Abstract
AIM:Develop a program to identify, treat, and prevent severe atrophic gastritis to reduce gastric cancer incidence and mortality. MAterials and Methods:In total, 2,847 people aged > 40 years old underwent serological noninvasive screening for atrophic gastritis by identifying postprandial gastrin-17 and pepsinogen-1 in the fasting state. Anti-H pylori IgG was found in 2,134 patients. Seven years later, 2,220 patientswho had undergone serological noninvasive screening were asked to fill out a questionnaire survey (were interviewed). We could not find any information on 627 of 2,847 patients. Next, 75 patients with multifocal atrophic gastritis who underwent gastroscopy and biopsies (the Updated Sydney System (USS)) were selected. To study gastrin-17 production, morpho-functional correlation was studies in 75 patients with multifocal atrophic gastritis. Results:During seven years, no reported case of gastric cancer was done among 2,220 persons who underwent serological screening and treatment. In the same population, 4.3 persons who did not receive screening during the same period, developed gastric cancer and died of it. In this study, we can say that 4.3 lives were saved out of 2,220 tested persons. The cost for screening this number of people amounted to €23,750. A comparison of the prevalence rate of the four stages of multifocal atrophic gastritis based on the data of the histopathology tests and noninvasive serologic screening in accordance with OLGA classification showed a strong correlation (the correlation coefficient is 0.812). This finding suggested that using this classification not only for histopathology tests for atrophic gastritis but also for serologic markers of antral mucosa and corpus ventriculi atrophy: gastrin-17 and pepsinogen-1. Conclusion:Complex pathogenetic treatment of atrophic gastritis significantly reduced gastric cancer risk and incidence for such patients.
Highlights
IntroductionFor the modern diagnostics of early stomach cancer, endoscopic monitoring of the stomach’s mucous membrane is required in patients with severe atrophic gastritis (Sugano et al, 2015; Choi, 2014)
It is possible to reduce stomach cancer mortality only in case of early detection
Evaluation of serologic markers for atrophic gastritis, such as gastrin-17, pepsinogen-1, pepsinogen-2, the pepsinogen-1/pepsinogen-2 ratio was developed by Biohit; this evaluation did not allow us to determin the degree of stomach mucous membrane atrophy in cases of atrophic gastritis
Summary
For the modern diagnostics of early stomach cancer, endoscopic monitoring of the stomach’s mucous membrane is required in patients with severe atrophic gastritis (Sugano et al, 2015; Choi, 2014). Many authors have suggested a method for serologic screening of atrophic gastritis based on the levels of substances produced by the antral mucosa and corpus ventriculi in blood serum (Kikuchi et al, 2011; Lijima et al, 2009; Germaná et al, 2005; Vaananen et al, 2003; Storskrubb et al, 2008). Evaluation of serologic markers for atrophic gastritis, such as gastrin-17, pepsinogen-1, pepsinogen-2, the pepsinogen-1/pepsinogen-2 ratio was developed by Biohit; this evaluation did not allow us to determin the degree of stomach mucous membrane atrophy in cases of atrophic gastritis. Many studies have shown poor sensitivity for serological assessment of atrophic gastritis because it does not account for the degree of antral mucosa and corpus ventriculi atrophy. Researchers keep studying the suggested atrophic gastritis serologic markers and searching for more accurate criteria to evaluate serologic screening results
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