Page 107 - Helicobacter pylori and Gastric Cancer: From Tumor microenvironment to Immunotherapy

Abstract
Atrophic gastritis (AG) and intestinal metaplasia (IM) are generally regarded as a precancerous condition associated with Helicobacter pylori and strongly predispose to the development of gastric cancer. Although the accurate diagnosis is essential for preventing gastric cancer, in practice many physicians rely solely on visual endoscopic inspection to rule out the presence of AG. It is thus important to verify the validity of such endoscopic inspection to the gold standard (histological diagnosis by the pathologist) in a variety of settings, also because incidence and presentation of AG is highly variable in geographical terms. This consideration prompted us to conduct a retrospective cohort study involving 248 patients of which, 124 are from low-incidence Nigeria and 124 from high incidence Iran, all aged 50±30 years. The extent of endoscopic atrophy was classified into five subgroups according to a modified Kimura–Takemoto classification system and was compared with histological findings of atrophy at five biopsy ,sites according to the updated Sydney system. The strength of agreement between endoscopic and histological atrophy was moderate and showed a substantial geographical discrepancy, indicating that relying solely on endoscopic screening for AG requires local validation.
Helicobacter Pylori
Helicobacter pylori
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