Editorial
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World J Gastroenterol. Mar 28, 2012; 18(12): 1279-1285
Published online Mar 28, 2012. doi: 10.3748/wjg.v18.i12.1279
Risk for gastric neoplasias in patients with chronic atrophic gastritis: A critical reappraisal
Lucy Vannella, Edith Lahner, Bruno Annibale
Lucy Vannella, Edith Lahner, Bruno Annibale, Dipartimento Medico-Chirurgico di Scienze Cliniche, Tecnobiomediche e Medicina Traslazionale, Sant’Andrea Hospital, School of Medicine, University Sapienza, Rome 00189, Italy
Author contributions: Vannella L contributed to the acquisition, analysis and interpretation of data and wrote the article; Lahner E critically revised the manuscript; Annibale B contributed to conception and design of the study and to final revision of the manuscript; all authors approved the version to be published.
Correspondence to: Bruno Annibale, Professor, Dipartimento Medico-Chirurgico di Scienze Cliniche, Tecnobiomediche e Medicina Traslazionale, Sant’Andrea Hospital, School of Medicine, University Sapienza, Rome 00189, Italy. bruno.annibale@uniroma1.it
Telephone: +39-6-4455292 Fax: +39-6-4455292
Received: August 15, 2011
Revised: November 15, 2011
Accepted: November 22, 2011
Published online: March 28, 2012
Abstract

Chronic atrophic gastritis (CAG) is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue (non-metaplastic atrophy) or by glandular structures inappropriate for location (metaplastic atrophy). Epidemiological data suggest that CAG is associated with two different types of tumors: Intestinal-type gastric cancer (GC) and type I gastric carcinoid (TIGC). The pathophysiological mechanisms which lead to the development of these gastric tumors are different. It is accepted that a multistep process initiating from Helicobacter pylori-related chronic inflammation of the gastric mucosa progresses to CAG, intestinal metaplasia, dysplasia and, finally, leads to the development of GC. The TIGC is a gastrin-dependent tumor and the chronic elevation of gastrin, which is associated with CAG, stimulates the growth of enterochromaffin-like cells with their hyperplasia leading to the development of TIGC. Thus, several events occur in the gastric mucosa before the development of intestinal-type GC and/or TIGC and these take several years. Knowledge of CAG incidence from superficial gastritis, its prevalence in different clinical settings and possible risk factors associated with the progression of this condition to gastric neoplasias are important issues. This editorial intends to provide a brief review of the main studies regarding incidence and prevalence of CAG and risk factors for the development of gastric neoplasias.

Keywords: Chronic atrophic gastritis; Gastric neoplasia; Intestinal-type gastric cancer; Type I gastric carcinoid; Prevalence; Incidence; Risk factors