Kotelevets SM, Chekh SA, Chukov SZ. Effectiveness of serological markers of gastric mucosal atrophy in the gastric precancer screening and in cancer prevention. World J Gastrointest Endosc 2024; 16(8): 462-471 [PMID: 39155993 DOI: 10.4253/wjge.v16.i8.462]
Corresponding Author of This Article
Sergey M Kotelevets, MD, Associate Professor, Department of Therapy, North Caucasus State Academy, Lenina Street, 75/32, Cherkessk 369000, Karachay-Cherkess Republic, Russia. smkotelevets@mail.ru
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Aug 16, 2024; 16(8): 462-471 Published online Aug 16, 2024. doi: 10.4253/wjge.v16.i8.462
Effectiveness of serological markers of gastric mucosal atrophy in the gastric precancer screening and in cancer prevention
Sergey M Kotelevets, Sergey A Chekh, Sergey Z Chukov
Sergey M Kotelevets, Department of Therapy, North Caucasus State Academy, Cherkessk 369000, Karachay-Cherkess Republic, Russia
Sergey A Chekh, Department of Mathematics, North Caucasus State Academy, Cherkessk 369000, Karachay-Cherkess Republic, Russia
Sergey Z Chukov, Department of Pathological Anatomy, Stavropol State Medical University, Stavropol 355017, Russia
Author contributions: Kotelevets SM and Chekh SA designed the study; Kotelevets SM performed the research, and wrote the paper; Chekh SA performed the statistical processing; Chukov SZ performed the histological research and biopsy assessment; Chekh SA and Chukov SZ revised the manuscript for final submission.
Institutional review board statement: The Institutional Review Board provided approval for this study (IRB No. 20/23, 2023 October 16).
Informed consent statement: All patients provided informed written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sergey M Kotelevets, MD, Associate Professor, Department of Therapy, North Caucasus State Academy, Lenina Street, 75/32, Cherkessk 369000, Karachay-Cherkess Republic, Russia. smkotelevets@mail.ru
Received: March 13, 2024 Revised: June 30, 2024 Accepted: July 25, 2024 Published online: August 16, 2024 Processing time: 141 Days and 10.4 Hours
Abstract
BACKGROUND
New markers are needed to improve the effectiveness of serological screening for atrophic gastritis.
AIM
To develop a cost-effective method for serological screening of atrophic gastritis with a high level of sensitivity.
METHODS
Of the 169 patients with atrophic gastritis, selected by the visual endoscopic Kimura-Takemoto method, 165 showed histological mucosal atrophy using the updated Kimura-Takemoto method. All 169 patients were examined for postprandial levels of gastrin-17 (G17) and pepsinogen-1 (PG1) using GastroPanel® (Biohit Plc, Helsinki, Finland).
RESULTS
We used the histological standard of five biopsies of the gastric mucosa, in accordance with the Kimura-Takemoto classification system to assess the sensitivity of G17 in detecting gastric mucosal atrophy. We also compared the morpho-functional relationships between the detected histological degree of gastric mucosal atrophy and the serological levels of G17 and PG1, as the markers of atrophic gastritis. The sensitivity of postprandial G17 was 62.2% for serological levels of G17 (range: 0-4 pmol/L) and 100% for serological G17 (range: 0-10 pmol/L) for the detection of monofocal severe atrophic gastritis. No strong correlation was found between the levels of PG1 and degree of histological atrophy determined by the Kimura-Takemoto classification system to identify the severity of mucosal atrophy of the gastric corpus. In the presented clinical case of a 63-year-old man with multifocal atrophic gastritis, there is a pronounced positive long-term dynamics of the serological marker of atrophy - postprandial G17, after five months of rennet replacement therapy.
CONCLUSION
Serological screening of multifocal atrophic gastritis by assessment of postprandial G17 is a cost-effective method with high sensitivity. Postprandial G17 is an earlier marker of regression of atrophic gastritis than a morphological examination of a gastric biopsy in accordance with the Sydney system. Therefore, postprandial G17 is recommended for dynamic monitoring of atrophic gastritis after treatment.
Core Tip: A new assessment of serological markers of atrophic gastritis has been developed and confirmed with application of the updated Kimura-Takemoto morphological classification system. Serological markers of atrophic gastritis in this new interpretation of the classification system can more accurately detect atrophy of the gastric mucosa and complementarily increase the effectiveness of previous technologies for serological screening of precancerous changes in the stomach. Ultimately, this new model of serological screening is highly sensitive for detecting atrophic gastritis across mild, moderate and severe degrees of disease progression.
