The efficacy of inclusion of chronic atrophic gastritis and Helicobacter pylori infection screening in health survey programs


DOI: https://dx.doi.org/10.18565/therapy.2023.7.8-14

Bakulin I.G., Sushilova A.G., Zharkov A.V.

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg
Abstract. Chronic atrophic gastritis (CAG) is the preneoplastic condition of gastric mucosa (GM). At the same time, the most frequent cause of HG is H. pylori infection.
The aim: to evaluate the efficacy of including the screening of CAG and H. pylori infection in the adult dispensarization to Identify stomach cancer in early stages.
Material and methods. The study included 1705 persons aged 21–81 years, whom were performed analyses of pepsinogen-I (PG-I), PG-II, gastrene-17 (M-17) and IgG antibodies to H. pylori in the blood serum. Persons with serological features of atrophy underwent the procedure of EGDS with GM biopsy according to OLGA standards. For H. pylori detection in biopsy samples, painting with hematoxylin and eosine by Romanovsky–Gymza was made.
Results. Obtained data, taking into account the methods of examination (serological method, morphological method of GM evaluation, calculation method) indicates that the prevalence of CAG among the adult population is 5,3%. As a result of the screening, the following cases were identified: 1 case (2,1% among CAG patients) of high degree dysplasia, 1 case (2,1%) – low-degree dysplasia, 2 cases (4,2%) – CAG with malignant stomach neoplasms, including 1 case of type 1 neuroendocrine tumor and 1 – with adenocarcinoma in situ. In all these 4 patients serological and morphological features of CAG were found. Serological markers of H. pylori infection (IgG antibodies) were found in 59,2% (1010 of 1705) cases, while 59,6% (56 of 94) - among individuals with laboratory criteria of CAG, in 47,9% (23 of 48) – in case of the presence of CAG histological signs. Maximal level of IgG (EIU) antibodies was fixed in middle (Me=72; 25–104), elderly (Me=39; 10–91) and senile age (ME=117; 101–132).
Conclusion. Screening of CAG and H. pylori infection with PG-I, PG-II, M-17 and IgG antibodies to H. pylori detection, followed by histological verification, serves as an effective version of screening program of stomach precancerous diseases and gastric cancer in the framework of the health survey of adult population of Russia. Target age group of the screening program are persons over 45 years.
Keywords: chronic atrophic gastritis, stomach cancer, screening
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Literature

1. Ferlay J., Colombet M., Soerjomataram I. et al. Cancer statistics for the year 2020: An overview. Int J Cancer. https://dx.doi.org/10.1002/ijc.33588. Online ahead of print.


2. Состояние онкологической помощи населению России в 2020 году. Под ред. А.Д. Каприна, В.В. Старинского, А.О. Шахзадовой. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России. 2021; 239 с. [The state of oncological care for the population of Russia in 2020. Ed. by Kaprin A.D., Starinsky V.V., Shahzadova A.O. Moscow: P. A. Herzen Moscow Cancer Research Institute – branch of National Medical Research Center of Radiology of the Ministry of Healthcare of Russia. 2021; 239 pp. (In Russ.)]. ISBN: 978-5-85502-275-9.


3. Malfertheiner P., Megraud F., Rokkas T. et al. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut. 2022: gutjnl-2022-327745. https://dx.doi.org/10.1136/gutjnl-2022-327745. Online ahead of print.


4. Areia M., Spaander M.C., Kuipers E.J., Dinis-Ribeiro M. Endoscopic screening for gastric cancer: A cost-utility analysis for countries with an intermediate gastric cancer risk. United European Gastroenterol J. 2018; 6(2): 192–202. https://dx.doi.org/10.1177/2050640617722902.


5. Bordin D., Morozov S., Plavnik R. et al. Helicobacter pylori infection prevalence in ambulatory settings in 2017–2019 in Russia: The data of real-world national multicenter trial. Helicobacter. 2022; 27(5): e12924. https://dx.doi.org/10.1111/hel.12924.


6. Бакулина Н.В., Симаненков В.И., Бакулин И.Г., Ильчишина Т.А. Распространенность хеликобактерной инфекции среди врачей. Экспериментальная и клиническая гастроэнтерология. 2017; (12): 20–24. [Bakulina N.V., Simanenkov V.I., Bakulin I.G., Ilchishina T.A. Prevalence of helicobacter pylori infection among physicians. Eksperimental’naya i klinicheskaya gastroenterologiya = Experimental and Clinical Gastroenterology. 2017; (12): 20–24 (In Russ)]. EDN: YOFUPS.


7. Захарова Н.В., Симаненков В.И., Бакулин И.Г. с соавт. Распространенность хеликобактерной инфекции у пациентов гастроэнтерологического профиля в Санкт-Петербурге. Фарматека. 2016; S5: 33–39. [Zaharova N.V., Simanenkov V.I., Bakulin I.G. et al. The prevalence of Helicobacter pylori infection in gastroenterological patients in St. Petersburg. Farmateka. 2016; S5: 33–39 (In Russ)]. EDN: XSDGAJ.


8. Yue H., Shan L., Bin L. The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: A systematic review and meta-analysis. Gastric Cancer. 2018; 21(4): 579–87. https://dx.doi.org/10.1007/s10120-018-0812-3.


9. Zhang H., Jin Z., Cui R. et al. Autoimmune metaplastic atrophic gastritis in Chinese: A study of 320 patients at a large tertiary medical center. Scand J Gastroenterol. 2017; 52(2): 150–56. https://dx.doi.org/10.1080/00365521.2016.1236397.


10. Murphy G., Dawsey S.M., Engels E.A. et al. Cancer risk after pernicious anemia in the US elderly population. Clin Gastroenterol Hepatol. 2015; 13(13): 2282–89.e1–4. https://dx.doi.org/10.1016/j.cgh.2015.05.040.


11. Vannella L., Sbrozzi-Vanni A., Lahner E. et al. Development of type I gastric carcinoid in patients with chronic atrophic gastritis. Aliment Pharmacol Ther. 2011; 33(12): 1361–69. https://dx.doi.org/10.1111/j.1365-2036.2011.04659.x.


12. Dilaghi E., Bellisario M., Esposito G. et al. The impact of proton pump inhibitors on the development of gastric neoplastic lesions in patients with autoimmune atrophic gastritis. Front Immunol. 2022; 13: 910077. https://dx.doi.org/10.3389/fimmu.2022.910077.


13. Цуканов В.В., Третьякова О.В., Амельчугова О.С. с соавт. Распространенность атрофического гастрита тела желудка у населения г. Красноярска старше 45 лет. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2012; 22(4): 27–31. [Tsukanov V.V., Tretyakova O.V., Amelchugova O.S. et al. The prevalence of atrophic gastritis of the body of stomach at Krasnoyarsk population over 45 years old. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii = Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2012; 22(4): 27–31 (In Russ)]. EDN: PIWDLZ.


14. Haziri A., Juniku-Shkololli A., Gashi Z. et al. Helicobacter pylori infection and precancerous lesions of the stomach. Med Arh. 2010; 64(4): 248–49.


15. Chen S., Ying L., Kong M. et al. The prevalence of Helicobacter pylori infection decreases with older age in atrophic gastritis. Gastroenterol Res Pract. 2013; 2013: 494783. https://dx.doi.org/10.1155/2013/494783.


16. Roman L.D., Lukyanchuk R., Sablin O.A. et al. Prevalence of H. pylori infection and atrophic gastritis in a population-based screening with serum biomarker panel (GastroPanel®) in St. Petersburg. Anticancer Res. 2016; 36(8): 4129–38.


17. Приказ Минздрава России от 27.04.2021 г. № 404н (ред. от 01.02.2022) «Об утверждении Порядка проведения профилактического медицинского осмотра и диспансеризации определенных групп взрослого населения» (зарегистрировано в Минюсте России 30.06.2021 г. № 64042). Доступ: https://gp219.mos.ru/images/doc/404n-22.pdf (дата обращения – 01.09.2023). [Order of the Ministry of Health of Russia dated April 27, 2021 No. 404n (as amended on February 1, 2022) «On approval of the Procedure for conducting a preventive medical examination and medical examination of certain groups of the adult population» (registered with the Ministry of Justice of Russia on June 30, 2021 No. 64042). URL: https://gp219.mos.ru/images/doc/404n-22.pdf (date of access – 01.09.2023) (In Russ)].


18. Бакулина Н.В., Маев И.В., Савилова И.В. с соавт. Эффективность эрадикации Helicobacter pylori в зависимости от генетического полиморфизма CYP2C19, MDR1 и IL-1β. Терапевтический архив. 2019; 91(8): 34–40. [Bakulina N.V., Maev I.V., Savilova I.V. et al. The effectiveness of Helicobacter pylori eradication depending on the genetic polymorphism of CYP2C19, MDR1 and IL-1β. Terapevticheskiy arkhiv = Therapeutic Archive. 2019; 91(8): 34–40 (In Russ)]. https://dx.doi.org/10.26442/00403660.2019.08.000380. EDN: MGABBW.


19. Di Mario F., Crafa P., Barchi A. et al. Pepsinogen II in gastritis and Helicobacter pylori infection. Helicobacter. 2022; 27(2): e12872. https://dx.doi.org/10.1111/hel.12872.


20. Chmiela M., Gonciarz W. Molecular mimicry in Helicobacter pylori infections. World J Gastroenterol. 2017; 23(22): 3964–77. https://dx.doi.org/10.3748/wjg.v23.i22.3964.


About the Autors

Igor G. Bakulin, MD, professor, head of the Department of propaedeutics of internal diseases, gastroenterology and dietology named after S.M. Ryss, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str.
E-mail: igbakulin@yandex.ru
ORCID: https://orcid.org/0000-0002-6151-2021
Anastasia G. Sushilova, postgraduate student of the Department of propaedeutics of internal diseases, gastroenterology and dietology named after S.M. Ryss, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str.
E-mail: anastasiya.s1311@gmail.com
ORCID: https://orcid.org/0000-0002-7277-5046
Alexander V. Zharkov, PhD in Medical Sciences, assistant at the Department of propaedeutics of internal diseases, gastroenterology and dietology named after S.M. Ryss, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str.
E-mail: al.zharkov@bk.ru
ORCID: https://orcid.org/0000-0001-9600-6649-0928


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