Chronic atrophic gastritis - preceding lesion of gastric cancer
DOI:
https://doi.org/10.52692/1857-0011.2025.1-81.26Keywords:
chronic atrophic gastritis, risk factors, GastroPanel, serological examination, endoscopic examination, morphological examination, Helicobacter pyloriAbstract
Chronic atrophic gastritis is a pre-neoplastic condition defined by the loss of gastric glandular structures that are replaced by connective tissue (non-metaplastic atrophy) or by inappropriate glandular structures (metaplastic atrophy) with a reduction in gastric secretory function. Annual incidence rates of chronic atrophic gastritis range from 0% to 10.9%. The estimated annual risk of progression of chronic atrophic gastritis to gastric adenocarcinoma varies between 0.1% and 0.3%, an indicator that can be higher (0.5-1%), depending on the severity of the disease, the extent of atrophy, the presence of gastric intestinal metaplasia and other factors.Chronic atrophic gastritis is usually asymptomatic and largely underdiagnosed. Non-specific gastric (epigastric pain, epigastric heartburn, regurgitation, feeling of postprandial fullness and feeling of early satiety) and extra-gastric symptoms can appear in the later evolution of the disease, and the patients in whom the diagnosis is established usually have advanced stages of the disease. Three methods are used to establish the diagnosis and extent of chronic atrophic gastritis: endoscopic evaluation, histological evaluation of biopsy samples, and serological results. However, due to non-specific clinical manifestations and low tolerance to invasive examinations, early diagnosis of the disease remains difficult in clinical practice. Management of chronic atrophic gastritis includes testing and eradication of HP infection, endoscopic surveillance every 3 years of patients with OLGA/OLGIM stages III/IV to increase the likelihood of detecting gastric cancer at an early stage when resection with curative intent is possible, and effective management of co-existing conditions associated with this condition.
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