Risk Of Chronic Atrophic Gastritis Research Articles

Prevalence of <i>Helicobacter pylori</i>-associated diseases in the Ural Federal District

Introduction Helicobacter pylori has the most pronounced oncogenic potential among known biological carcinogens of humans. Helicobacter positivity leads to the development of chronic gastritis and with prolonged persistence of infection in the gastric mucosa it is associated with the development of atrophic gastritis and adenocarcinoma of the stomach. According to international data, the prevalence of infection in Russia corresponds to the level of countries with low socio-economic status. The domestic literature contains data for a limited number of reggions, such as North-West Russia, Siberia and the Far East.The aim of the study was to determine the prevalence of Helicobacter pylori infection and chronic atrophic gastritis among patients residing in the Ural Federal District and to identify risk factors for these diseases using modern diagnostic methods used in clinical practice.Materials and methods Observational non-interventional anonymous cross-sectional study of 11,721 primary patients among those tested for H. pylori infection residing in the Ural Federal District. 13C-urease breath test was performed in 10,882 patients, FGDS with gastric mucosal biopsy according to OLGA and histological evaluation of biopsy specimens – in 839 patients.Results The prevalence of H. pylori infection among primary care patients by 13C-UT was 46.9 % and that of chronic atrophic gastritis by histological evaluation of a biopsy specimen was 24.9 %. The risk of chronic atrophic gastritis was higher in those infected with H. pylori (OR 1.71; 95 % CI: 1.24–2.37, p = 0.002) and in patients over 60 years old.Discussion The resulting prevalence of H. pylori infection in the Ural Federal District is below the levels reported in the current literary for Russia. The increasing prevalence of infection with age confirms the principle that the prevalence of infection depends on changing socio-economic conditions in a generation. The observed prevalence of chronic atrophic gastritis is comparable with the national data. The risk of gastric mucosal atrophy increases with age and in the presence of H. pylori infection, which prompts active screening of gastropathology in this category of individuals.Conclusion The prevalence of H. pylori infection and atrophic gastritis among primary patients, as determined by reference diagnostics, was 46.9 % and 24.9 %, respectively.

Characteristics of Helicobacter pylori-Seropositive Subjects According to: A) The Stool Antigen Test Findings. B) Serum Pepsinogen Level. C) Upper Endoscopic Findings

Abstract Background Helicobacter pylori infection can be diagnosed by invasive methods using the gastric biopsied specimens or non-invasively by examining serum, urine, breath, or stool. Histological examination by Giemsa staining is usually recommended for the diagnosis, but it is difficult to visualize the bacterium when there is alow density of H.Pylori on the gastric mucosa with atrophic and metaplastic changes, Limitations of histological examination include increased false negative test findings due to various density of H. pylori at a different sites, high cost, long turn-around time, and inter observer variability. Therefore, in endemic countries like Egypt with s higher risk of chronic atrophic gastritis (CAG), intestinal metaplasia, and gastric cancer, noninvasive tests need to be added for a more reliable diagnosis of H.Pylori infection. Aim of the Work The aim of this study is to compare between the prevalence of chronic atrophic gastritis (CAG) and gastric corpus atrophy in Helicobacter pyloriseropositive subjects according to the stool antigen test, serum pepsinogen(PG) level and upper endoscopic findings. Patients and Methods The current study represents Cross- sectional study -Descriptive -Diagnostic study. This study had been carried at Ain Shams University and Abbasia fever hospital on 80 seropositive- patients attending to endoscopy ward for a regular check-up, All patients subjected to full history, clinical examination and investigation in the form of; complete blood count, serum antiH.Pylori immunoglobulin G (IgG), stool antigen test and serum pepsinogen. Results The current study showed that there was a significant difference between positive and negative H. pylori regarding pepsinogen I & II and endoscopic finding regarding CAG and CSG. Conclusion In conclusion, there is a link between positive stool H. pylori antigen test findings and a serum PG assay and upper endoscopic findings in seropositive subjects. Positive stool H. pylori antigen test findings are common in seropositive subjects with increased serum PG I levels indicating an ongoing H. pylori infection. Our study findings further suggest that, to reduce the infected subjects with H. pylori in their fecal material, seropositive subjects with increased gastric secreting ability need to be treated.

Analysis of high risk factors for chronic atrophic gastritis.

Screening for chronic atrophic gastritis (CAG) is crucial for the prevention and early detection of gastric cancer. Endoscopy is the main method of CAG diagnosis, with high training requirements and limited accuracy, making it difficult to popularize. The study attempts to improve the positive rate and accuracy of CAG screening through non-invasive testing. A total of 2564 patients who underwent gastroscopy were included in this study. The results of gastroscopic evaluation, histological biopsy results (including H. pylori biopsy), urea breath test (UBT) results, serum pepsinogen, and testosterone were statistically analyzed. We found significant differences in the diagnosis of CAG between endoscopy and histological biopsy. Pepsinogen II and pepsinogen I/II ratio were more useful for the diagnosis of CAG compared with pepsinogen I. The risk of CAG was increased when pepsinogen II exceeded 11.05 μg/L, and the pepsinogen I/II ratio was less than 3.75. CAG positivity was higher in patients with positive H. pylori infection on UBT screening. In addition, higher levels of testosterone, SHBG and HSD17B2, and lower level of GNRH1 were found in CAG mucosa. Patients with high serum testosterone had a higher risk of CAG. CAG screening should be combined with endoscopic evaluation, biopsy, and other non-invasive tests. Non-invasive tests include the combination of serum pepsinogen II protein and pepsinogen I/II ratio and high level of serum testosterone. UBT combined with serum pepsinogen testing may improve the positive rate of CAG and reduce gastric mucosal damage from multiple biopsies.

Prevalence of chronic atrophic gastritis worldwide from 2010 to 2020: an updated systematic review and meta-analysis.

Gastric cancer ranks 4th in cancer incidence and ranks 2nd in leading to cancer-related deaths worldwide. The present study aimed to provide an updated overview of the prevalence of chronic atrophic gastritis (CAG), one of the precancerous lesions of gastric cancer, in the recent 10 years and its association with Helicobacter pylori (HP) infection. A meta-analysis of follow-up studies worldwide in the recent 10 years was performed by systematically searching in Web of Science, PubMed, Cochrane, and Embase. A total of 14 studies were finally enrolled in the present meta-analysis. The pooled results showed that the prevalence of CAG was about 25% in the study population, and the risk of CAG was about 2.4-fold higher in HP-positive patients than in those who were HP negative. Subgroup analyses showed that both the prevalence of CAG and the risk of CAG in HP-positive patients were higher when infection was diagnosed by histology than by serology. The worldwide prevalence of CAG is still high, and HP infection remains an important risk factor for CAG. Future studies of large-scale are still in urgent need to further control the prevalence of CAG, so as to reduce the burden of gastric cancer.

Epistatic SNP interaction of ERCC6 with ERCC8 and their joint protein expression contribute to gastric cancer/atrophic gastritis risk.

Excision repair cross-complementing group 6 and 8 (ERCC6 and ERCC8) are two indispensable genes for the initiation of transcription-coupled nucleotide excision repair pathway. This study aimed to evaluate the interactions between single nucleotide polymorphisms of ERCC6 (rs1917799) and ERCC8 (rs158572 and rs158916) in gastric cancer and its precancerous diseases. Besides, protein level analysis were performed to compare ERCC6 and ERCC8 expression in different stages of gastric diseases, and to correlate SNPs jointly with gene expression. Sequenom MassARRAY platform method was used to detect polymorphisms of ERCC6 and ERCC8 in 1916 subjects. In situ ERCC6 and ERCC8 protein expression were detected by immunohistochemistry in 109 chronic superficial gastritis, 109 chronic atrophic gastritis and 109 gastric cancer cases. Our results demonstrated pairwise epistatic interactions between ERCC6 and ERCC8 SNPs that ERCC6 rs1917799-ERCC8 rs158572 combination was associated with decreased risk of chronic atrophic gastritis and increased risk of gastric cancer. ERCC6 rs1917799 also showed a significant interaction with ERCC8 rs158916 to reduce gastric cancer risk. The expressions of ERCC6, ERCC8 and ERCC6-ERCC8 combination have similarities that higher positivity was observed in chronic superficial gastritis compared with chronic atrophic gastritis and gastric cancer. As for the effects of ERCC6 and ERCC8 SNPs on the protein expression, single SNP had no correlation with corresponding gene expression, whereas the ERCC6 rs1917799–ERCC8 rs158572 pair had significant influence on ERCC6 and ERCC6-ERCC8 expression. In conclusion, ERCC6 rs1917799, ERCC8 rs158572 and rs158916 demonstrated pairwise epistatic interactions to associate with chronic atrophic gastritis and gastric cancer risk. The ERCC6 rs1917799–ERCC8 rs158572 pair significantly influence ERCC6 and ERCC6-ERCC8 expression.

Molecular Pathological Epidemiology in Helicobacter Pylori Infection and Risk of Chronic Atrophic Gastritis

Helicobacter pylori (H. pylori) infects more than 50% of the global population and has been identified as the most important risk factor (cause) of chronic atrophic gastritis (CAG), the main precursor lesion of gastric cancer (GC). Regular endoscopic examination and worry of development of GC bring these CAG patients serious physical, psychological and economic burden. However, most of the H. pylori-infected patients will not progress to the development of CAG, not to speak of GC, through their lives. Therefore, if we can classify all the H. pylori-infected patients according to the risk of CAG, most of them would be relieved from their burden. Molecular pathological epidemiology (MPE) is a new interdisciplinary, transdisciplinary and multidisciplinary study field, which has emerged as an integrated approach of molecular pathology and epidemiology, and investigates the relationships between molecular characteristics or molecular changes, exogenous and endogenous exposure factors, and initiation, evolution, progression, and response to treatment of diseases. According to the principle and methods, MPE may be a promising approach to achieve our purpose. Moreover, the MPE can provide some very important insights on the molecular mechanisms, personalized prevention and treatment for the study field of H. pylori infection and CAG.

A novel model might predict the risk of chronic atrophic gastritis: a multicenter prospective study in China

Objective. To find a new way to predict the risk of chronic atrophic gastritis (CAG). Material and methods. All the participants received endoscopy and histological examination as well as a standard questionnaire. Multivariate analysis was performed by logistic regression to build the CAG risk model. The accuracy was evaluated by 1418 subjects recruited from six medical centers. 63 subjects received another endoscopy after 1-year follow-up and divided into three groups according to the comparison of the histological results (improved, no change and worse). Results. The model showed relatively good discrimination, with an AUROC of 0.888 (95% CI 0.852–0.925). A final probability cut-off score of 0.73 was used to predict the presence (>0.73) or absence of CAG (≤0.73). Sensitivity, specificity, PPV and NPV were 82.8%, 74.7%, 91.8% and 56%, respectively. The predicted results of 1418 subjects compared with the histological results were quite similar. There was a significant difference of the scores between three groups who were followed-up for 1 year (F = 3.248, p = 0.046). In multiple comparisons, a significant difference existed between Group A (the histological results had improved after 1-year follow-up) and Group C (the results were worse) (p = 0.019). Conclusions.This is the first demonstration of the use of a mathematical model for CAG risk screening. Endoscopy should be recommended to those who are positive according to the model, to detect CAG early and conserve medical resources. In those who have a high-risk score, closer follow-up is needed.

DNA repair gene polymorphisms and risk of chronic atrophic gastritis: a case-control study

BackgroundRecent studies have reported associations of DNA repair pathway gene variants and risk of various cancers and precancerous lesions, such as chronic atrophic gastritis (CAG).MethodsA nested case-control study within the German population-based ESTHER cohort was conducted, including 533 CAG cases and 1054 controls. Polymorphisms in eleven DNA repair genes (APEX1, ERCC1, ERCC2/XPD, PARP1 and XRCC1), in CD3EAP/ASE-1 and PPP1R13L were analysed.ResultsNo association was disclosed for any of the analysed polymorphisms. Nor did stratified analyses according to ages < 65 and ≥ 65 years show any significant association with CAG risk.ConclusionsThe results of this large German case-control study do not reveal associations of DNA repair pathway polymorphisms and risk of CAG. On the basis of a large number of CAG cases, they do not support associations of DNA repair pathway SNPs with CAG risk, but suggest the need of larger studies to disclose or exclude potential weak associations, or of studies with full coverage of candidate genes.

Polymorphisms in MUC1, MUC2, MUC5B and MUC6 genes are not associated with the risk of chronic atrophic gastritis

Mucins represent major components of the mucous layer in the stomach, protecting the underlying epithelium from acid, mechanical trauma, proteases and pathogenic bacteria. Previous studies have shown an association of neoplastic transformation in the stomach with aberrant mucin levels, suggesting a potential role of genetic variation in mucin genes in the development of gastric cancer (GC). We assessed the association of genetic variation in candidate single nucleotide polymorphisms (SNPs) in mucin genes with the risk of chronic atrophic gastritis (CAG), a well-established precursor of GC in the German population-based ESTHER study. We genotyped MUC1 T31T, MUC2 L58P, MUC2 V116M, MUC5B E34G, MUC5B R51W, MUC5B rs2014486 (intronic) and MUC6 V619M for 533 serologically defined CAG cases and 1054 age- and sex-matched controls. None of the analysed SNPs was associated with CAG. However, large studies are needed to disclose or exclude potential weak associations of these SNPs with CAG risk.

Alcohol consumption and chronic atrophic gastritis: Population‐based study among 9,444 older adults from Germany

Moderate alcohol consumption has been suggested to facilitate elimination of Helicobacter pylori infection which is a key risk factor for chronic atrophic gastritis (CAG) and gastric cancer. The aim of our study was to assess the association of alcohol consumption with CAG among older adults from Germany. In the baseline examination of ESTHER, a population-based study conducted in Saarland, serological measurements of pepsinogen I and II (for CAG definition) and H. pylori antibodies were taken in 9,444 subjects aged 50-74 years. Moderate current (<60 g/week) and lifetime (<or=51,376 g, lowest quartile) alcohol consumption were found to be associated with significantly reduced CAG risk compared to alcohol abstinence with adjusted odds ratios of 0.71 (0.55-0.90) and 0.73 (0.55-0.96), respectively. Inverse associations with CAG were observed for moderate alcohol consumption from both beer and wine, and were slightly attenuated after additional adjustment for H. pylori infection. Our results are consistent with the hypothesis that moderate alcohol consumption may be inversely related to CAG, partly through facilitating the elimination of H. pylori. However, the observed patterns suggest that other mechanisms are likely to contribute to the association as well.

Sibship size, Helicobacter pylori infection and chronic atrophic gastritis: a population-based study among 9444 older adults from Germany

Early-life social environment has been suggested to play an important role during the development of Helicobacter pylori-related gastric diseases. We aimed to assess the association of sibship size with H. pylori infection and chronic atrophic gastritis (CAG) in a population-based study from Germany. In the baseline examination of ESTHER, a study conducted in Saarland, serological measurements of pepsinogen I and II and H. pylori antibodies were taken in 9444 participants aged 50-74 years. Information on potential risk factors and medical history were obtained by self-administered standardized questionnaire. A strong dose-response relationship between sibship size and H. pylori seroprevalence was observed (P < 0.01). Adjusted odds ratios (ORs) 95% confidence interval (CI) for H. pylori seropositivity for subjects with 4, 5, 6 and 7 or more siblings compared with subjects without siblings were 1.45 (1.20-1.77), 1.83 (1.50-2.22) and 1.84 (1.47-2.31), respectively. A large sibship size was also associated with an increased risk of CAG with an adjusted OR of 1.42 (1.01-2.01) for 7 or more compared with less than or equal to 2 siblings. This association was attenuated but not entirely eliminated after additional adjustment for H. pylori infection. Notably, a significant association between large sibship size and CAG was also found among H. pylori-negative subjects. Our results suggest that large sibship size is associated with increased H. pylori prevalence and CAG risk. The association with CAG risk may be mediated at least in part by H. pylori infection. However, mechanisms other than H. pylori infection may contribute to the 'sibling effect' as well.

Association between Chronic Atrophic Gastritis and Serum Antibodies to 15 Helicobacter pylori Proteins Measured by Multiplex Serology

Infection with Helicobacter pylori is a major risk factor for chronic atrophic gastritis (CAG), a precursor lesion of intestinal gastric cancer. The pathogenicity of the bacterium is thought to play an important role in determining the extent and severity of clinical outcome. We aimed to assess the associations between CAG and the serostatus of antibodies to 15 H. pylori proteins. The analyses were based on 534 cases with serologically defined CAG and 1,068 age-matched and sex-matched controls participating in a population-based study conducted in Saarland, Germany among 9,953 men and women ages 50 to 74 years. A newly developed H. pylori multiplex serology method was used to detect antibodies specific to 15 H. pylori antigens. Significant associations were observed between seropositivity for all 15 specific antibodies and the presence of CAG. Exclusion of severe cases, who might have lost the infection in the course of CAG progression, substantially increased the observed associations. In H. pylori-seropositive subjects, cytotoxin-associated gene A (CagA), vacuolating toxin (VacA), helicobacter cysteine-rich protein C (HcpC), and the chaperonin GroEL were identified as independent virulence factors for CAG with adjusted odds ratios (95% confidence interval) of 3.52 (2.01-6.10), 3.19 (1.44-7.05), 4.03 (1.53-10.65), and 2.65 (1.06-6.62), respectively; the simultaneous presence of all four independent virulence factors was associated with an 18-fold risk of CAG. In conclusion, HcpC and GroEL were identified as new independent virulence factors, and in combination with the established virulence factors, CagA and VacA, were strongly associated with CAG.

Association between a pro-inflammatory genetic profile and the risk of chronic atrophic gastritis among older adults from Germany

BackgroundPro-inflammatory polymorphisms have been suggested to explain part of the individual diversity in susceptibility to gastric carcinogenesis. We aimed to assess their impact on the risk of chronic atrophic gastritis (CAG) in a population-based study. MethodsAmong 9953 older adults from Saarland/Germany, eight single nucleotide polymorphisms (SNPs) were assessed for 534 cases with serologically defined CAG and 534 age- and sex-matched controls at baseline examination. ResultsOf the 8 SNPs, only IL10 T-819C showed a borderline significant association with CAG risk (odds ratio for CC versus TT: 1.67 (95% confidence interval: 1.01–2.76)). No significant differences were observed for the distribution of inferred haplotypes between cases and controls. However, joint evaluation of several cytokine variants suggested an increased risk of CAG among individuals carrying several pro-inflammatory genotypes. ConclusionsOur findings suggest that a pro-inflammatory genetic profile may contribute to inter-individual variation in gastric cancer risk by increasing the susceptibility to the development of CAG.

A pro-inflammatory genetic profile increases the risk of chronic atrophic gastritis and gastric carcinoma

A pro-inflammatory genetic profile increases the risk of chronic atrophic gastritis and gastric carcinoma

Relation of Helicobacter pylori infection and lifestyle to the risk of chronic atrophic gastritis: a cross-sectional study in Japan.

To examine the mutual association of risk factors for both Helicobacter pylori (H. pylori) infection and chronic atrophic gastritis (CAG), a cross-sectional study on 954 residents of a rural town in Japan was conducted. Using an unconditional logistic model, we calculated the odds ratios (ORs) for H. pylori infection according to each lifestyle, as well as the ORs for CAG according to each lifestyle and H. pylori infection. A significant positive association was observed between H. pylori infection and the risk of CAG (OR = 6.29). On the other hand, a significant negative association was observed between high consumption of light-colored vegetables and the risk of CAG (OR = 0.68). We also used a path analysis to examine the direct relations of gender, age, and lifestyle variables to CAG, as well as the indirect relations of these variables to CAG through H. pylori infection. Aging had a significantly direct positive association with CAG. Although aging also had an indirect positive association with CAG through H. pylori infection, aging had no association with the consumption of light-colored vegetables. The high consumption of light-colored vegetables showed no association with H. pylori infection but had a significantly direct negative association with CAG. The results of this study suggest a possibility that high light-colored vegetables consumption contributes to the prevention of CAG.

Serum anti-helicobacter pylori antibodies and the risk of chronic atrophic gastritis and gastric cancer

Serum anti-helicobacter pylori antibodies and the risk of chronic atrophic gastritis and gastric cancer

Relationship between Serologically Diagnosed Chronic Atrophic Gastritis, Helicobacter pylori, and Environmental Factors in Japanese Men

Background: Whereas chronic atrophic gastritis is known to be an intermediate stage in gastric carcinogenesis, information is sparse about factors associated with this precancerous lesion except for Helicobacter pylori. Methods: In a cross-sectional study of 566 men aged 50-55 years in the Japan Self-Defense Forces, we examined the relation of H. pylori infection, smoking, alcohol use, and dietary factors to the prevalence of chronic atrophic gastritis as determined by serum pepsinogen I and pepsinogen II (I/II ratio < 3.0, and pepsinogen I < 70 ng/ml). Chronic atrophic gastritis was classified as severe when the pepsinogen I/II ratio was <2.0, and as moderate otherwise. Results: The overall prevalence of chronic atrophic gastritis was 35.7% (202 of 566). The seropositivity of H. pylori was associated with a 10-fold increase in the risk of chronic atrophic gastritis, and the association was much stronger for moderate atrophic gastritis. Neither cigarette smoking nor alcohol consumption was related to the overall risk of chronic atrophic gastritis. Consumption of vegetables and fruits was each unrelated to chronic atrophic gastritis whether examined as a whole or separately for moderate and severe atrophic gastritis. Green tea was related to decreased risk of severe atrophic gastritis, although not statistically significant, whereas garlic consumption showed no protective association. Conclusions: The findings corroborate that H. pylori infection has an important role in the development of chronic atrophic gastritis in middle-aged Japanese men. Green tea consumption may be protective against the advance of atrophic gastritis. Vegetables, fruits, or garlic had no protective effect against the development of atrophic gastritis in the study.

Green tea consumption and chronic atrophic gastritis: a cross-sectional study in a green tea production village.

Chronic atrophic gastritis (CAG) is well known as a precancerous lesion of the stomach, and Helicobacter pylori (H. pylori) infection increases the risk of CAG. While recent studies have reported that green tea consumption decreases the risk of gastric cancer, there has been no study analyzing the relationship between green tea consumption and the both risks H. pylori infection and CAG. We conducted a cross-sectional study on 636 subjects living in a farming village in Japan to examine the relationship among green tea consumption, H. pylori infection, and CAG. Smoking, alcohol drinking, consumption of four beverages, including green tea, and of five foods were investigated as lifestyle factors that may affect H. pylori infection and CAG. The measurement of H. pylori-IgG antibodies was used to define H. pylori infection, and serum pepsinogens were used to define of CAG. The unconditional logistic regression model was used for analyzing each odds ratio (OR). H. pylori infection was positively associated with the risk of CAG (OR = 3.73; 95% confidence interval [CI], 2.59-5.36). High green tea consumption (more than 10 cups per day) was negatively associated with the risk of CAG, even after adjustment for H. pylori infection and lifestyle factors associated with green tea consumption (OR = 0.63; 95% CI, 0.43-0.93). These results support the hypothesis that high green tea consumption prevents CAG.