Gastritis: The clinico-pathological spectrum. Issue 10 (October 2021)

• Record Type: Journal Article
• Authors: Rugge, Massimo; Savarino, Edoardo; Sbaraglia, Marta; Bricca, Ludovica; Malfertheiner, Peter
• Is Part Of: Digestive and liver disease. Volume 53:Issue 10(2021)
• Page Start: 1237
• Page End: 1246
• Publication Date: 2021-10
• Subjects: Atrophic gastritis -- Atrophic border -- Autoimmune gastritis -- Gastric biopsy protocol -- Gastric cancer -- Gastric metaplasia -- Intestinal Metaplasia -- OLGA staging -- SPEM; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2021.03.007
• Languages: English
• ISSNs: 1590-8658

Abstract

Summary: The inflammatory spectrum of gastric diseases includes different clinico-pathological entities, the etiology of which was recently established in the international Kyoto classification. A diagnosis of gastritis combines the information resulting form the gross examination (endoscopy) and histology (microscopy). It is important to consider the anatomical/functional heterogeneity of the gastric mucosa when obtaining representative mucosal biopsy samples. Gastritis includes self-limiting and non-self-limiting (long-standing) inflammatory diseases, and the latter are epidemiologically, biologically and clinically linked to the onset of gastric cancer ( i.e. "inflammation-associated cancer"). Different biological models of inflammation-associated gastric oncogenesis have been proposed. Helicobacter pylori ( H. pylori ) gastritis is the most prevalent worldwide, and H. pylori is classified as a first-class carcinogen. On these bases, eradicating H. pylori is mandatory for the primary prevention of gastric cancer. Non-self-limiting gastritis may also be triggered by the immune-mediated destruction of gastric parietal cells, resulting in autoimmune gastritis. In both H. pylori -related and autoimmune gastritis, the non-self-limiting inflammation results in atrophy of the gastric mucosa, which is the main factor promoting gastric cancer. Long-term follow-up studies consistently demonstrate the prognostic impact of the histological staging of gastritis in gastric cancer secondary prevention strategies.