Gastric Intestinal Metaplasia: Challenges and the Opportunity for Precision Prevention
Abstract
:Simple Summary
Abstract
1. Introduction
2. Background
2.1. Global Burden of Gastric Cancer
2.2. Gastric Intestinal Metaplasia as a Premalignant State
3. Predictors of Progression of Gastric IM
3.1. Clinical Features
3.2. Endoscopic Features
Study | Participants | Study Design | Endoscope | Magnification | Sensitivity | Specificity |
---|---|---|---|---|---|---|
Uedo et al. (2006) [75] | 107 Japan | Prospective | GIF-Q240Z | 80× (optical) | 89% (83–96%) | 93% (88–97%) |
An et al. (2012) [62] | 47 South Korea | Prospective | GIF-H260Z | 85× (optical) | 72.1% | 96.0% |
Savarino et al. (2013) [76] | 100 Italy | Prospective | GIF-Q160Z | 115× (optical) | 80% (67–92%) | 96% (93–99%) |
Ang et al. (2015) [65] | 458 Asia Pacific | Prospective | GIF-290 and 190 | Unclear | 92.3% (80.6–97.5%) | 94.3% (85.3–98.3%) |
Drasovean et al. (2018) [77] | 59 Romania | Prospective | HQ-190 | 150× (optical) | 80.43% (70.9–88%) | 80% (69.9–87.9%) |
Sobrino-Cossio et al. (2018) [69] | 338 Mexico | Retrospective | H-180 | 1.5× (digital) | 85% (76.7–91.4%) | 98% (96.7–98.9%) |
3.3. Histologic Features
3.4. Current Guidelines
4. Future Directions
4.1. Approaches to Population-Level Screening and Surveillance
4.2. Artificial Intelligence and Machine Learning
4.3. Biomarkers
4.4. Genomic, Epigenomic and Molecular Markers Uncover the Pathogenesis of IM and Stratify Risk
4.5. Microbiome and the Immune Landscape
4.6. Utilising Integrated Variables to Increase Precision of Risk Prediction
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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CORPUS (BODY) | |||||
Atrophy Score | No atrophy (0) | Mild atrophy (1) | Moderate atrophy (2) | Severe atrophy (3) | |
ANTRUM (INCLUDING INCISURA) | No atrophy (0) | Stage 0 | Stage I | Stage II | Stage II |
Mild atrophy (1) | Stage I | Stage I | Stage II | Stage III | |
Moderate atrophy (2) | Stage II | Stage II | Stage III | Stage IV | |
Severe atrophy (3) | Stage III | Stage III | Stage IV | Stage IV | |
CORPUS (BODY) | |||||
IM Score | No IM (0) | Mild IM (1) | Moderate IM (2) | Severe IM (3) | |
ANTRUM (INCLUDING INCISURA) | No IM (0) | Stage 0 | Stage I | Stage II | Stage II |
Mild IM (1) | Stage I | Stage I | Stage II | Stage III | |
Moderate IM (2) | Stage II | Stage II | Stage III | Stage IV | |
Severe IM (3) | Stage III | Stage III | Stage IV | Stage IV |
ESGE (2019) | BSG (2019) | AGA (2020) | |
---|---|---|---|
Extensive IM | Thrice yearly | Thrice yearly | Routine surveillance not recommended. Patients with GIM at higher risk for gastric cancer who place high value on potential but uncertain reductions in gastric cancer mortality, and who place a low value on the potential risks of surveillance endoscopies, may reasonably elect for surveillance. Consider surveillance 3–5 times a year. |
Limited IM, no risk factors | No surveillance | No surveillance | |
Limited IM, family history OR incomplete or persistent H pylori | Thrice yearly | Thrice yearly | |
Limited IM, severe atrophy | Thrice yearly | Thrice yearly | |
Limited IM, severe atrophy, family history | Considered 1–2 times a year | Thrice yearly | |
Autoimmune gastritis | Considered 3–5 times a year |
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Tjandra, D.; Busuttil, R.A.; Boussioutas, A. Gastric Intestinal Metaplasia: Challenges and the Opportunity for Precision Prevention. Cancers 2023, 15, 3913. https://doi.org/10.3390/cancers15153913
Tjandra D, Busuttil RA, Boussioutas A. Gastric Intestinal Metaplasia: Challenges and the Opportunity for Precision Prevention. Cancers. 2023; 15(15):3913. https://doi.org/10.3390/cancers15153913
Chicago/Turabian StyleTjandra, Douglas, Rita A. Busuttil, and Alex Boussioutas. 2023. "Gastric Intestinal Metaplasia: Challenges and the Opportunity for Precision Prevention" Cancers 15, no. 15: 3913. https://doi.org/10.3390/cancers15153913