Gastritis: An Update in 2020
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Stomach (P Malfertheiner, Section Editor)
Gastritis: An Update in 2020 Massimo Rugge, MD1,2,* Kentaro Sugano3 Diana Sacchi1 Marta Sbaraglia1 Peter Malfertheiner4 Address 1 Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Via A. Gabelli, 61, 35121, Padova, Italy *,2 Veneto Tumor Registry (RTV), Veneto Regional Authority, Padova, Italy Email: [email protected] 3 Department of Medicine, Jichi Medical University, Tochigi, Japan 4 Department of Internal Medicine II, Hospital of the Ludwig Maximilian University of Munich, Munich, Germany
* The Author(s) 2020
This article is part of the Topical Collection on Stomach Keywords Atrophic gastritis I OLGA staging I Gastric oncogenesis I Intestinal metaplasia I Helicobacter pylori I Spasmolytic peptide expressing mucosa
Abstract Purpose of review The gastritis constellation includes heterogeneous clinicopathological entities, among which long-standing, non-self-limiting gastritis, mainly due to Helicobacter pylori infection, has been epidemiologically, biologically, and clinically linked to gastric cancer development (i.e. “inflammation-associated cancer”). This review illustrates the updated criteria applied in the taxonomy of gastritis (Kyoto classification), elucidates the biological rationale for endoscopy biopsy sampling (heterogeneity of gastric mucosa), and finally reports the results of long-term follow-up studies supporting the reliability of biopsy-based gastritis staging as predictor of gastritis-associated cancer risk. Recent findings By assuming gastric atrophy as the “cancerization field” where (nonsyndromic) gastric cancer mostly develops, recent long-term follow-up studies consistently demonstrate the prognostic impact of the gastritis OLGA staging system. Summary Helicobacter pylori eradication is the leading strategy in the primary prevention of gastric cancer. In a multidisciplinary dimension of secondary cancer prevention, the OLGA staging system reliably ranks the patient-specific cancer risk, thus providing the clinical rationale for a tailored follow-up strategy.
Stomach (P Malfertheiner, Section Editor)
Introduction The “gastritis” label is extensively (but inappropriately) applied to a spectrum of clinical symptoms relating to the upper abdomen, and the epigastrium in particular. The correct medical definition for this cluster of symptoms is dyspepsia. More strictly speaking, in the absence of organic disorders, the various combinations of upper digestive symptoms (e.g. bothersome postprandial fullness, early satiation, epigastric pain, and epigastric burning) should be defined as functional dyspepsia. There is an update on the (sub)types of functional dyspepsia at the Rome IV conference [1, 2]. At endoscopy, gastritis is described as any reddening or edema of the gastric mucosa, but neither of these endoscopic features is specific or exclusive to mucosal inflammation. A Japanese study on the accuracy of standard endoscopic imaging for the detection of H. pylori infection reported accuracy of 89%
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