Gastric atrophy and intestinal metaplasia represent the most important premalignant lesions in gastric carcinogenesis. The severity of gastric mucosal inflammation depends on the bacterium Helicobacter pylori (HP), on...Gastric atrophy and intestinal metaplasia represent the most important premalignant lesions in gastric carcinogenesis. The severity of gastric mucosal inflammation depends on the bacterium Helicobacter pylori (HP), on the host and on environmental factors. The aim of our study is to determine the prevalence and factors associated with Gastric atrophy and intestinal metaplasia in patients infected with Helicobacter pylori. Methods: This is a prospective study over a period of 4 years (May 2009 - January 2015) conducted in the service of Hepatology and Gastroenterology in hospital university Hassan II of Fez in collaboration with microbiology and molecular biology laboratory and epidemiology service of Faculty of Medicine and Pharmacy Fes. We included in our study all patients aged over 15 years, having ulcerative dyspepsia, peptic ulcer disease, gastritis or esophagitis. Results: During the study period, 1190 patients were included of which 70% had HP infection (N = 833). The average age was 48.21 years [16 - 99 years], sex ratio M/F was 1, 11. 60% of patients were older than 45 years. Chronic smoking was found in 12% of patients. Gastric atrophy was observed in 84% (N = 699) of patients infected with HP. Gastric atrophy was localized in 70% in the antrum and 30% in the fundus and 24% in both. The activity of gastritis (p = 0.0001) and the density of the HP (p = 0.005) were factors associated with atrophy. Intestinal metaplasia was observed in 13.5% of patients (N = 112). The density of HP (p = 0.037) and severe atrophy (p = 0.001) were factors associated with metaplasia. Other factors studied: age, sex, smoking, CagA<sup>+</sup> genotype were not associated with either gastric atrophy or intestinal metaplasia. Conclusion: In our study, the prevalence of atrophic gastritis and intestinal metaplasia in patients infected with Helicobacter pylori was 84% and 13.5% respectively, which was a high prevalence. The activity of gastritis, and density of HP were factors associated with atrophy. The density of HP and severe atrophy were factors associated with metaplasia.展开更多
BACKGROUND Atrophic gastritis is a precancerous lesion of the stomach.It has been reported that pepsinogen(PG)can reflect the morphology and function of the gastric mucosa,and it is therefore used as a marker for the ...BACKGROUND Atrophic gastritis is a precancerous lesion of the stomach.It has been reported that pepsinogen(PG)can reflect the morphology and function of the gastric mucosa,and it is therefore used as a marker for the early diagnosis of atrophic gastritis.AIM To evaluate the diagnostic value of serum PG for degree of gastric mucosal atrophy in asymptomatic Chinese upon physical examination.METHODS Medical data were collected from subjects who underwent transnasal gastroscopy between October 2016 and October 2018.For each study subject,serum PG levels and presence of Helicobacter pylori(H.pylori)infection were investigated.Pathology was evaluated using the Operative Link for Gastritis Assessment(OLGA)classification and Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)systems.All statistical analyses were carried out using SPSS statistical software.RESULTS A total of 2256 subjects were enrolled and 1922 cases were finally included in the study.Based on the OLGA grading system,the levels of PGI were slightly decreased,while those of PGII were slightly increased.The PGI/PGII ratio(PGR)was reduced with increasing atrophy.The association between PG and OLGA grading was higher compared with that between PG and the OLGIM grading system.Compared with the OLGA-0 group,a statistically significant difference was observed in the mean age of OLGA-Ⅰ,Ⅲ,and Ⅳ groups(P<0.05).In the H.pylori-positive subjects,the PGR levels were notably lower in the OLGA-Ⅰ,Ⅱ,and Ⅲ groups compared with the OLGA-0 group(P<0.05).H.pylori-positive subjects exhibited significantly higher PGI and PGII serum levels and a significantly lower PGR compared with H.pylori-negative patients in different OLGA groups(P<0.05).CONCLUSION Serum PG levels may represent a non-invasive screening marker for gastric mucosal atrophy in asymptomatic subjects.展开更多
BACKGROUND Advances in endoscopic imaging enable the identification of patients at high risk of gastric cancer.However,there are no comparative data on the utility of standard and magnifying narrow-band imaging(M-NBI)...BACKGROUND Advances in endoscopic imaging enable the identification of patients at high risk of gastric cancer.However,there are no comparative data on the utility of standard and magnifying narrow-band imaging(M-NBI)endoscopy for diagnosing Helicobacter pylori(H.pylori)infection,gastric atrophy,and intestinal metaplasia.AIM To compare the diagnostic performance of standard and M-NBI endoscopy for H.pylori gastritis and precancerous conditions.METHODS In 254 patients,standard endoscopy findings were classified into mosaic-like appearance(type A),diffuse homogenous redness(type B),and irregular redness with groove(type C).Gastric mucosal patterns visualized by M-NBI were classified as regular round pits with polygonal sulci(type Z-1),more dilated and linear pits without sulci(type Z-2),and loss of gastric pits with coiled vessels(type Z-3).RESULTS The diagnostic accuracy of standard and M-NBI endoscopy for H.pylori gastritis was 93.3%and 96.1%,respectively.Regarding gastric precancerous conditions,the accuracy of standard and M-NBI endoscopy was 72.0%vs 72.6%for moderate to severe atrophy,and 61.7%vs.61.1%for intestinal metaplasia in the corpus,respectively.Compared to type A and Z-1,types B+C and Z-2+Z-3 were significantly associated with moderate to severe atrophy[odds ratio(OR)=5.56 and 8.67]and serum pepsinogen I/II ratio of≤3(OR=4.48 and 5.69).CONCLUSION Close observation of the gastric mucosa by standard and M-NBI endoscopy is useful for the diagnosis of H.pylori gastritis and precancerous conditions.展开更多
Gastric cancer(GC)is a multifactorial disease,where both environmental and genetic features can have an impact on its occurrence and development.GC represents one of the leading causes of cancer-related deaths worldwi...Gastric cancer(GC)is a multifactorial disease,where both environmental and genetic features can have an impact on its occurrence and development.GC represents one of the leading causes of cancer-related deaths worldwide.GC is most frequent in males and is believed to arise from a series of premalignant lesions.The detection of GC at an early stage is crucial because early GC,which is an invasive stomach cancer confined to the mucosal or submucosal lining,may be curable with a reported 5-year survival rate of more than 90%.Advanced GC usually has a poor prognosis despite current treatment standards.The diagnostic efficacy of conventional endoscopy(with light endoscopy)is currently limited.Confocal laser endomicroscopy is a novel imaging technique that allows real-time in vivo histological examination of mucosal surfaces during endoscopy.Confocal laser endomicroscopy may be of great importance in the surveillance of precancerous gastric lesions and in the diagnosis of GC.In this editorial we commented on the article about this topic published by Lou et al in the recent issue of the World Journal of Clinical Cases.展开更多
AIM:To study the association between Helicobacter pylori(H.pylori)infection and autoimmune type atrophic gastritis. METHODS:Twenty-three patients with different grades of atrophic gastritis were analysed using enzyme ...AIM:To study the association between Helicobacter pylori(H.pylori)infection and autoimmune type atrophic gastritis. METHODS:Twenty-three patients with different grades of atrophic gastritis were analysed using enzyme immunoassay-based serology,immunoblot-based serology,and histology to reveal a past or a present H.pylori infection.In addition,serum markers for gastric atrophy(pepsinogenⅠ,pepsinogenⅠ/Ⅱand gastrin)and autoimmunity[parietal cell antibodies(PCA), and intrinsic factor(IF),antibodies]were determined. RESULTS:Of the 14 patients with severe gastricatrophy,as demonstrated by histology and serum markers,and no evidence for an ongoing H.pylori infection,eight showed H.pylori antibodies by immunoblotting.All eight had elevated PCA and 4/8 also had IF antibodies.Of the six immunoblot-negative patients with severe corpus atrophy,PCA and IF antibodies were detected in four.Among the patients with low to moderate grade atrophic gastritis(all except one with an ongoing H.pylori infection),serum markers for gastric atrophy and autoimmunity were seldom detected.However,one H.pylori negative patient with mild atrophic gastritis had PCA and IF antibodies suggestive of a pre-atrophic autoimmune gastritis. CONCLUSION:Signs of H.pylori infection in autoimmune gastritis,and positive autoimmune serum markers in H.pylori gastritis suggest an etiological role for H.pylori in autoimmune gastritis.展开更多
文摘Gastric atrophy and intestinal metaplasia represent the most important premalignant lesions in gastric carcinogenesis. The severity of gastric mucosal inflammation depends on the bacterium Helicobacter pylori (HP), on the host and on environmental factors. The aim of our study is to determine the prevalence and factors associated with Gastric atrophy and intestinal metaplasia in patients infected with Helicobacter pylori. Methods: This is a prospective study over a period of 4 years (May 2009 - January 2015) conducted in the service of Hepatology and Gastroenterology in hospital university Hassan II of Fez in collaboration with microbiology and molecular biology laboratory and epidemiology service of Faculty of Medicine and Pharmacy Fes. We included in our study all patients aged over 15 years, having ulcerative dyspepsia, peptic ulcer disease, gastritis or esophagitis. Results: During the study period, 1190 patients were included of which 70% had HP infection (N = 833). The average age was 48.21 years [16 - 99 years], sex ratio M/F was 1, 11. 60% of patients were older than 45 years. Chronic smoking was found in 12% of patients. Gastric atrophy was observed in 84% (N = 699) of patients infected with HP. Gastric atrophy was localized in 70% in the antrum and 30% in the fundus and 24% in both. The activity of gastritis (p = 0.0001) and the density of the HP (p = 0.005) were factors associated with atrophy. Intestinal metaplasia was observed in 13.5% of patients (N = 112). The density of HP (p = 0.037) and severe atrophy (p = 0.001) were factors associated with metaplasia. Other factors studied: age, sex, smoking, CagA<sup>+</sup> genotype were not associated with either gastric atrophy or intestinal metaplasia. Conclusion: In our study, the prevalence of atrophic gastritis and intestinal metaplasia in patients infected with Helicobacter pylori was 84% and 13.5% respectively, which was a high prevalence. The activity of gastritis, and density of HP were factors associated with atrophy. The density of HP and severe atrophy were factors associated with metaplasia.
基金Supported by National Natural Science Foundation of China,No.71804161,No.72074188。
文摘BACKGROUND Atrophic gastritis is a precancerous lesion of the stomach.It has been reported that pepsinogen(PG)can reflect the morphology and function of the gastric mucosa,and it is therefore used as a marker for the early diagnosis of atrophic gastritis.AIM To evaluate the diagnostic value of serum PG for degree of gastric mucosal atrophy in asymptomatic Chinese upon physical examination.METHODS Medical data were collected from subjects who underwent transnasal gastroscopy between October 2016 and October 2018.For each study subject,serum PG levels and presence of Helicobacter pylori(H.pylori)infection were investigated.Pathology was evaluated using the Operative Link for Gastritis Assessment(OLGA)classification and Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)systems.All statistical analyses were carried out using SPSS statistical software.RESULTS A total of 2256 subjects were enrolled and 1922 cases were finally included in the study.Based on the OLGA grading system,the levels of PGI were slightly decreased,while those of PGII were slightly increased.The PGI/PGII ratio(PGR)was reduced with increasing atrophy.The association between PG and OLGA grading was higher compared with that between PG and the OLGIM grading system.Compared with the OLGA-0 group,a statistically significant difference was observed in the mean age of OLGA-Ⅰ,Ⅲ,and Ⅳ groups(P<0.05).In the H.pylori-positive subjects,the PGR levels were notably lower in the OLGA-Ⅰ,Ⅱ,and Ⅲ groups compared with the OLGA-0 group(P<0.05).H.pylori-positive subjects exhibited significantly higher PGI and PGII serum levels and a significantly lower PGR compared with H.pylori-negative patients in different OLGA groups(P<0.05).CONCLUSION Serum PG levels may represent a non-invasive screening marker for gastric mucosal atrophy in asymptomatic subjects.
基金the Soonchunhyang University Research Fund,No.20200023.
文摘BACKGROUND Advances in endoscopic imaging enable the identification of patients at high risk of gastric cancer.However,there are no comparative data on the utility of standard and magnifying narrow-band imaging(M-NBI)endoscopy for diagnosing Helicobacter pylori(H.pylori)infection,gastric atrophy,and intestinal metaplasia.AIM To compare the diagnostic performance of standard and M-NBI endoscopy for H.pylori gastritis and precancerous conditions.METHODS In 254 patients,standard endoscopy findings were classified into mosaic-like appearance(type A),diffuse homogenous redness(type B),and irregular redness with groove(type C).Gastric mucosal patterns visualized by M-NBI were classified as regular round pits with polygonal sulci(type Z-1),more dilated and linear pits without sulci(type Z-2),and loss of gastric pits with coiled vessels(type Z-3).RESULTS The diagnostic accuracy of standard and M-NBI endoscopy for H.pylori gastritis was 93.3%and 96.1%,respectively.Regarding gastric precancerous conditions,the accuracy of standard and M-NBI endoscopy was 72.0%vs 72.6%for moderate to severe atrophy,and 61.7%vs.61.1%for intestinal metaplasia in the corpus,respectively.Compared to type A and Z-1,types B+C and Z-2+Z-3 were significantly associated with moderate to severe atrophy[odds ratio(OR)=5.56 and 8.67]and serum pepsinogen I/II ratio of≤3(OR=4.48 and 5.69).CONCLUSION Close observation of the gastric mucosa by standard and M-NBI endoscopy is useful for the diagnosis of H.pylori gastritis and precancerous conditions.
文摘Gastric cancer(GC)is a multifactorial disease,where both environmental and genetic features can have an impact on its occurrence and development.GC represents one of the leading causes of cancer-related deaths worldwide.GC is most frequent in males and is believed to arise from a series of premalignant lesions.The detection of GC at an early stage is crucial because early GC,which is an invasive stomach cancer confined to the mucosal or submucosal lining,may be curable with a reported 5-year survival rate of more than 90%.Advanced GC usually has a poor prognosis despite current treatment standards.The diagnostic efficacy of conventional endoscopy(with light endoscopy)is currently limited.Confocal laser endomicroscopy is a novel imaging technique that allows real-time in vivo histological examination of mucosal surfaces during endoscopy.Confocal laser endomicroscopy may be of great importance in the surveillance of precancerous gastric lesions and in the diagnosis of GC.In this editorial we commented on the article about this topic published by Lou et al in the recent issue of the World Journal of Clinical Cases.
文摘AIM:To study the association between Helicobacter pylori(H.pylori)infection and autoimmune type atrophic gastritis. METHODS:Twenty-three patients with different grades of atrophic gastritis were analysed using enzyme immunoassay-based serology,immunoblot-based serology,and histology to reveal a past or a present H.pylori infection.In addition,serum markers for gastric atrophy(pepsinogenⅠ,pepsinogenⅠ/Ⅱand gastrin)and autoimmunity[parietal cell antibodies(PCA), and intrinsic factor(IF),antibodies]were determined. RESULTS:Of the 14 patients with severe gastricatrophy,as demonstrated by histology and serum markers,and no evidence for an ongoing H.pylori infection,eight showed H.pylori antibodies by immunoblotting.All eight had elevated PCA and 4/8 also had IF antibodies.Of the six immunoblot-negative patients with severe corpus atrophy,PCA and IF antibodies were detected in four.Among the patients with low to moderate grade atrophic gastritis(all except one with an ongoing H.pylori infection),serum markers for gastric atrophy and autoimmunity were seldom detected.However,one H.pylori negative patient with mild atrophic gastritis had PCA and IF antibodies suggestive of a pre-atrophic autoimmune gastritis. CONCLUSION:Signs of H.pylori infection in autoimmune gastritis,and positive autoimmune serum markers in H.pylori gastritis suggest an etiological role for H.pylori in autoimmune gastritis.