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Evaluation of the Gastric Microbiome in Patients with Chronic Superficial Gastritis and intestinal metaplasia

Chinese Medical Sciences Journal 2022年第1期37卷 44-51页

作者： Ying Liu Yongjun Ma Caiqun Huang Department of Clinical Laboratory Jinhua Municipal Central HospitalJinhuaZhejiang321000China Department of Central Laboratory Jinhua Municipal Central HospitalJinhuaZhejiang321000China

Objective To evaluate the gastric microbiome in patients with chronic superficial gastritis(CSG)and intestinal metaplasia(IM)and investigate the influence of Helicobacter pylori(H.pylori)on the gastric microbiome.Methods Gastric mucosa tissue samples were collected from 54 patients with CSG and IM,and the patients were classified into the following four groups based on the state of H.pylori infection and histology:H.pylori-negative CSG(n=24),H.pylori-positive CSG(n=14),H.pylori-negative IM(n=11),and H.pylori-positive IM(n=5).The gastric microbiome was analyzed by 16S rRNA gene sequencing.Results H.pylori strongly influenced the bacterial abundance and diversity regardless of CSG and IM.In H.pylori-positive subjects,the bacterial abundance and diversity were significantly lower than in H.pylori-negative subjects.The H.pylori-negative groups had similar bacterial composition and bacterial abundance.The H.pylori-positive groups also had similar bacterial composition but different bacterial relative abundance.The relative abundance of Neisseria,Streptococcus,Rothia,and Veillonella were richer in the I-HP group than in G-HP group,especially Neisseria(t=175.1,P<0.001).Conclusions The gastric microbial abundance and diversity are lower in H.pylori-infected patients regardless of CSG and IM.Compared to H.pylori-positive CSG group and H.pylori-positive IM,the relative abundance of Neisseria,Streptococcus,Rothia,and Veillonella is higher in H.pylori-positive patients with IM than in H.pylori-positive patients with CSG,especially Neisseria.

关键词： chronic superficial gastritis intestinal metaplasia Helicobacter pylori gastric microbiome

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History of chronic gastritis:How our perceptions have changed

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World Journal of Gastroenterology 2024年第13期30卷 1851-1858页

作者： Dmitry Bordin Maria Livzan Department of Pancreatic Biliary and Upper GI Tract DiseasesA.S.Loginov Moscow Clinical Scientific CenterMoscow 111123Russia Department of Propaedeutic of Internal Diseases and Gastroenterology Russian University of MedicineMoscow 127006Russia Department of Outpatient Therapy and Family Medicine Tver State Medical UniversityTver 170100Russia Department of Internal Medicine and Gastroenterology Omsk State Medical UniversityOmsk 644099Russia

Currently,the diagnostic strategy for chronic gastritis(CG)is aimed not just at fixing the presence of gastric mucosal inflammation,but also at gastric cancer(GC)risk stratification in a particular patient.Modern classification approach with the definition of the stage of gastritis determines the need,activities and frequency of dynamic monitoring of a patient.However,this attitude to the patient suffering from CG was far from always.The present publication is a literature review describing the key milestones in the history of CG research,from the description of the first observations of inflammation of the gastric mucosa,assessment of gastritis as a predominantly functional disease,to the advent of endoscopy of the upper digestive tract and diagnostic gastric biopsy,assessment of the role of Helicobacter pylori infection in progression of inflammatory changes to atrophy,intestinal metaplasia,dysplasia and GC.

关键词： Chronic gastritis intestinal metaplasia Dysplasia Gastric cancer Helicobacter pylori

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Inflammatory cytokine gene polymorphisms increase the risk of atrophic gastritis and intestinal metaplasia

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World Journal of Gastroenterology 2010年第14期16卷 1788-1794页

作者： Li, Zhong-Wu Wu, Ying Sun, Yu Liu, Lu-Ying Tian, Meng-Meng Feng, Guo-Shuang You, Wei-Cheng Li, Ji-You Peking Univ Key Lab Carcinogenesis & Translat Res Minist Educ Dept PatholSch OncolBeijing Canc Hosp & Inst Beijing 100142 Peoples R China Peking Univ Key Lab Carcinogenesis & Translat Res Minist Educ Dept EpidemiolSch OncolBeijing Canc Hosp & Inst Beijing 100142 Peoples R China

AIM: To investigate the effects of interleukin-8 (IL-8 ), macrophage migration inhibitory factor (MIF ) gene polymorphisms, Helicobacter pylori (H. pylori ) infection, on the risk of developing severe chronic atrophic gastritis (SCAG) and intestinal metaplasia (IM). METHODS: A total of 372 cases were selected from a cohort study in Linqu County, a high risk area for gastric cancer (GC) in northern China. To obtain a sufficient group size, patients with normal or superficial gastritis were included. Based on an average follow-up period of 56 mo, the 372 cases were divided into no progres-sion group (no histological progression from normal or superficial gastritis, n = 137), group Ⅰ (progressed from normal or superficial gastritis to SCAG, n = 134) and group Ⅱ (progressed from normal or superficial gastritis to IM, n = 101). IL-8 , MIF gene polymorphisms were detected by polymerase chain reaction-based denaturing high-performance liquid chromatography analysis and DNA sequencing. RESULTS: An increased risk of SCAG was found in subjects with IL-8-251 AA genotype [odds ratio (OR) = 2.62, 95% CI: 1.23-5.72] or IL-8-251 A allele carriers (AA + AT) (OR = 1.81, 95% CI: 1.06-3.09). An elevated risk of IM was found in subjects with IL-8-251 AT genotype (OR = 2.27, 95% CI: 1.25-4.14) or IL-8-251 A allele carriers (OR = 2.07, 95% CI: 1.16-3.69). An increased risk of SCAG was found in subjects with MIF-173 GC genotype (OR = 2.36, 95% CI: 1.38-4.02) or MIF-173 C allele carriers (GC + CC) (OR = 2.07, 95% CI: 1.21-3.55). An elevated risk of IM was found in subjects with MIF-173 CC genotype (OR = 2.27, 95% CI: 1.16-4.46) or MIF-173 C allele carriers (OR = 3.84, 95% CI: 1.58-9.34). The risk of SCAG and IM was more evident in subjects carrying IL-8-251 A allele (OR = 6.70, 95% CI: 1.29-9.78) or MIF-173 C allele (OR = 6.54, 95% CI: 2.97-14.20) and positive for H. pylori infection. CONCLUSION: IL-8-251 and MIF-173 gene polymorphisms are significantly associated with the risk of SCAG and IM in a population with a high risk of GC in Li

关键词： Chronic atrophic gastritis Gene polymorphisms Helicobacter pylori Interleukin-8 intestinal metaplasia Macrophage migration inhibitory factor

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Lamb’s tripe extract and vitamin B12 capsule plus celecoxib reverses intestinal metaplasia and atrophy:A retrospective cohort study

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World Journal of Clinical Cases 2021年第34期9卷 10472-10483页

作者： Si-Ran Wu Jie Liu Li-Feng Zhang Na Wang Lu-Yao Zhang Qiong Wu Jun-Ye Liu Yong-Quan Shi State Key Laboratory of Cancer Biology National Clinical Research Center for Digestive DiseasesXijing HospitalAir Force Military Medical UniversityXi'an 710032Shaanxi ProvinceChina Department of Clinical Nutrition Xijing HospitalAir Force Military Medical UniversityXi'an 710032Shaanxi ProvinceChina Department of Radiation Protective Medicine Air Force Military Medical UniversityXi'an 710032Shaanxi ProvinceChina

BACKGROUND Chronic atrophic gastritis(AG)with intestinal metaplasia(IM)significantly increases the risk of gastric cancer.Some medicines have showed definite therapeutic effects in AG and IM regression.AIM To validate the efficacy of Lamb’s tripe extract and vitamin B12 capsule(LTEVB12)initial therapy and celecoxib rescue therapy for IM and AG.METHODS A total of 255 patients were included to receive LTEVB12 initial therapy(2 capsules each time,three times daily for 6 mo)in hospital in this study.The patients with failure of IM regression continued to receive celecoxib rescue therapy(200 mg,once daily for 6 mo).After each therapy finished,the patients underwent endoscopy and biopsy examination.The regression efficiency was assessed by the operative link on gastritis assessment(OLGA)and the operative link on the gastric intestinal metaplasia assessment(OLGIM)staging system.Logistic regression analysis was applied to identify factors associated with the curative effect.RESULTS For LTEVB12 initial therapy,the reversal rates of IM and AG were 52.95%and 48.24%,respectively.Analogously,for celecoxib rescue therapy,the effective rates for IM and AG were 56.25%and 51.56%,respectively.The IM regression rate of complete therapy was up to 85.03%.In different OLGA and OLGIM stages of IM patients,therapeutic efficiency showed a significant difference in each group(P<0.05).For both therapies,patients with high stages(III or IV)of both the OLGA and OLGIM evaluation systems showed a higher IM or AG regression rate than those with low stages(I or II).Among patients with high stages(OLGIM III and IV),the IM regression rate was above 70%for each therapy.Eating habits,fresh vegetable intake,and high-salt diet were identified as independent factors for the IM reversal effect of LTEVB12 therapy,especially high-salt diet(odds ratio=1.852,P<0.05).CONCLUSION Monotherapy could reverse IM and AG.LTEVB12 initial therapy and celecoxib rescue therapy significantly increase the regression effect.IM may not be the point of no return among gastri

关键词： Atrophy gastritis intestinal metaplasia Celecoxib Stomach neoplasms Operative link on the gastric intestinal metaplasia assessment Operative link on the gastritis assessment

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Comparison of operative link for gastritis assessment, operative link on gastric intestinal metaplasia assessment, and TAIM stagings among men with atrophic gastritis

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World Journal of Gastroenterology 2020年第24期26卷 3447-3457页

作者： Anna A Nieminen Jukka Kontto Pauli Puolakkainen Jarmo Virtamo Arto Kokkola Department of Surgery Abdominal CenterHelsinki University Hospital and University of HelsinkiHelsinki 00290Finland Department of Public Health Solutions National Institute for Health and Welfare(THL)Helsinki 00271Finland

BACKGROUND Gastric cancer is the world’s third most lethal malignancy. Most gastric cancers develop through precancerous states of atrophic gastritis and intestinal metaplasia. Two staging systems, operative link for gastritis assessment(OLGA)and operative link on gastric intestinal metaplasia assessment(OLGIM), have been developed to detect high gastric cancer risk. European guidelines recommend surveillance for high-risk OLGA/OLGIM patients(stages Ⅲ–Ⅳ),and for those with advanced stage of atrophic gastritis in the whole stomach mucosa. We hypothesize, that by combining atrophy and intestinal metaplasia into one staging named TAIM, more patients with increased gastric cancer risk could be detected.AIM To evaluate the clinical value of the OLGA, OLGIM, and novel TAIM stagings as prognostic indicators for gastric cancer.METHODS In the Helsinki Gastritis Study, 22346 elderly male smokers from southwestern Finland were screened for serum pepsinogen I(PGI). Between the years 1989 and1993, men with low PGI values(PGI intestinal metaplasia in gastric biopsies. In TAIM staging, the gastric cancer risk is classified as low or high.RESULTS Twenty-eight gastric cancers were diagnosed during the follow-up, and the incidence rate was 1.72 per 1000 patient-years. The cancer risk associated positively with TAIM [Hazard ratio(HR) 2.70, 95%CI: 1.09–6.69, P = 0.03]. The risk increased through OLGIM stages 0-Ⅳ(0 vs Ⅳ: HR 5.72, 95%CI: 1.03–31.77, P for trend = 0.004), but not through OLGA stages 0–Ⅳ(0 vs Ⅳ: HR 5.77, 95%CI:0.67–49.77, P for trend = 0.10). The sensitivities of OLGA and OLGIM stages Ⅲ–Ⅳ were low, 21% and 32%, respectively, whereas that of TAIM high-risk was good, 79%. On the contrary, OLGA and

关键词： Operative link for gastritis assessment Operative link on gastric intestinal metaplasia assessment TAIM Atrophic gastritis intestinal metaplasia Gastric cancer

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Long-term Follow-up Study on Gastric intestinal metaplasia Subtype and Its Relation to Expression of P53,Bcl-2 and PCNA

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Chinese Journal of Cancer Research 2009年第4期21卷 272-277页

作者： Yu Sun Zhong-Wu Li Guo-Shuang Feng Ji-You Li Key Laboratory of Carcinogenesis and Translational Research （Ministry of Education） Department of Pathology Peking University School of Oncology Beijing Cancer Hospital ＆ Institute Beijing 100142 China Chaoyang District Center for Disease Control and Prevention Beijing China

Objective： To investigate the correlation of typies of gastric intestinal metaplasia（IM）, expression of p53, bcl-2 and the proliferating cell nuclear antigen（PCNA）, with the lesion＇s evolution. Methods： A total of 80 patients with IM（53 male and 27 female, 35-64 years old） from an area with high-risk of gastric cancer（GC） in China were enrolled into this prospective study, including 28 cases of type Ⅰ （complete）, 25 cases of type Ⅱ （incomplete） , and 27 cases of type Ⅲ （incomplete）. Of the 80 cases, 62 cases including 19 cases of type Ⅰ, 22 type Ⅱ and 21 type Ⅲ, were followed up for 5-14 years（49 cases for 14 years, 6 for 10 years, and 7 for 5 years）. All of the 80 cases were studied immunohistochemically for the expression of p53, bcl-2 and PCNA. Results： The rate of p53-expressing cases was higher in type Ⅲ（25.9%） than in type Ⅰ（10.7%） and type Ⅱ （12.0%）, but without statistical significance（P=0.3070）. The positive rate of bcl-2 was obviously lower in type Ⅰ （21.4%） and type Ⅱ （24.0%） than in type Ⅲ（37.0%）, but not statistically significant（P=0.4223）. We observed difference in PCNA labelling index （LI） between type Ⅱ and type Ⅲ（P=0.0037）, and the difference was particularly significant in type Ⅰ as compared with type Ⅲ（P〈0.0001）. There was no statistical significance between type I and type II （P=0.0616）. Evolution into GC was detected in 0%, 4.5%, and 14.3% of type Ⅰ, type Ⅱ, and type Ⅲ IM cases, respectively. Progression to dysplasia was detected in 31.6%, 18.2%, and 14.3% of type Ⅰ, type Ⅱ, and type Ⅲ IM cases, respectively. Persistence of IM was documented in 31.6%, 45.5%, and 42.9% of type Ⅰ, type Ⅱ, and type Ⅲ IM cases, respectively. Regression of IM was documented in 36.8%, 31.8%, and 28.6% of type Ⅰ, type Ⅱ, and type ⅢIM cases, respectively. In progressive, persistent and regressive groups, the positive rates of p53 were 17.6%, 16.0% and 15.0%, bcl-2 were 29.4%, 36.0% and 25.0%, and PCNA LIs were 24.953±14.477, 23.752±12.934 and 25.105±10.055, respectively. There were no significant differences bet

关键词： intestinal metaplasia Subtype Follow-up Immunohistochemistry Gastric cancer

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Prevalence and Factors Associated with intestinal metaplasia in Chronic Helicobacter pylori Gastritis in a Country with High Endemicity: Ivory Coast Case

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Open Journal of Gastroenterology 2023年第12期13卷 401-410页

作者： Hatrydt Guillaume Dimitri Kouamé Lisiane Mewetieh Kouassi Olivier Claver Koffi Bathaix Fulgence Mamert Yao Medical Sciences Training and Research Unit of Abidjan Félix Houphou&#235t-Boigny University Abidjan Ivory Coast Hepatology and Gastroenterology Unit Yopougon University Hospital Abidjan Ivory Coast

Context/Objective: Few studies have been carried out in a country with high endemicity for Helicobacter pylori (H. pylori) infection in Sub-Saharan Africa looking for the association of intestinal metaplasia (IM) with chronic gastritis. We hypothesize that IM is correlated with the intensity of H. pylori infection in a country with high endemicity, Ivory Coast. The objective of this study was to determine the prevalence of intestinal metaplasia in chronic H. pylori gastritis in Ivory Coast. Methods: This was a prospective, cross-sectional, multicenter study, carried out over a period of 5 months, in the reference hospital centers of Abidjan, specialized in Gastroenterology. All patients who had undergone Gastroscopy with biopsies according to the criteria of the Sydney System for the anatomopathological study, those with chronic gastritis and/or H. pylori intestinal metaplasia on histology and in whom all the parameters of the Sydney system classification had been well informed. The quantitative variables were expressed by their means accompanied by their standard deviations and the qualitative variables by their numbers and percentages. Chi-square and Fischer tests were used to look for associations between variables. The significance level was set at 5%. Results: 152 patients were retained. The mean age was 44.9 ± 12.9 years. The prevalence of intestinal metaplasia was 11.8%. In univariate analysis, no significant association was found between clinical and pathological sociodemographic factors (age, sex, ethnicity, educational level, profession) and intestinal metaplasia in chronic Helicobacter pylori gastric cases. In multivariate analysis we found that prolonged use of Proton Pump Inhibitors (PPIs) and a history of Gastroesophageal Reflux Disease (GERD) were significantly associated with the absence of IM. Conclusion: Chronic H. pylori gastritis is the main risk factor for intestinal metaplasia. Prolonged use of PPIs and a history of GERD were significantly identified as factors that would protect against int

关键词： Helicobacter Pylori Chronic Gastritis intestinal metaplasia Ivory Coast

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Induction of intestinal metaplasia in stomach of dogs and expression of tumor-related proteins in animal gastric mucosa lesions

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Chinese Medical Journal 2000年第4期 48-51页

作者：王东旭房殿春刘为纹

Objective To observe the development and progression of intestinal metaplasia (IM) in dog's stomach and expression of tumor related proteins in gastric mucosa lesions Methods IM animal model was induced in stomach of Beagle dog by combining treatment of oral administration of N methyl N' nito N nitrosoguanidine (MNNG) and ranitidine (R) with X ray irradiation to the target organ Expression of APC, p53, K ras and bcl 2 gene proteins in animal gastric mucosa lesions were determined with immunohistochemical method Results IM animal model was successfully induced and the dynamic pathological changes were observed by means of this model It was confirmed that the progression from normal epithelial cells to IM cells may require several stages, including superficial gastritis, chronic atrophic gastritis, slight focal IM and moderate or severe IM Aberrant bcl 2 protein can be detected in the atrophic mucosa epithelium and the abnormal expression of APC, K ras and bcl 2 can be found in IM of mucosa Conclusions IM model in stomach of Beagle dog can be successfully induced by our method (MNNG+R+ X ray) The progression from normal to IM in dog resembles that of human being and the expression of tumor related proteins (APC, bcl 2, K ras) may play a role in the malignant transformation of IM

关键词： Beagle dog intestinal metaplasia animal model tumor related gene protein expression

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Gastric Atrophy, intestinal metaplasia in Helicobacter pylori Gastritis: Prevalence and Predictors Factors

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Journal of Biosciences and Medicines 2016年第10期4卷 43-49页

作者： S. Adadi B. Bennani M. Elabkari A. Ibrahimi S. Alaoui M. Elkhadir T. Harmouch M. Mahmoud C. Nejjari D. Benajah Service of Hepatology and Gastroenterology Hassan II University Hospital of Fez University Sidi Mohamed Ben Abdellah Fez Morocco Microbiology and Molecular Biology Laboratory Hassan II University Hospital of Fez University Sidi Mohamed Ben Abdellah Fez Morocco Service of Pathology Hassan II University Hospital of Fez University Sidi Mohamed Ben Abdellah Fez Morocco Service of Biology Hassan II University Hospital of Fez University Sidi Mohamed Ben Abdellah Fez Morocco Service of épidémiology Hassan II University Hospital of Fez University Sidi Mohamed Ben Abdellah Fez Morocco

Gastric atrophy and intestinal metaplasia represent the most important premalignant lesions in gastric carcinogenesis. The severity of gastric mucosal inflammation depends on the bacterium Helicobacter pylori (HP), on the host and on environmental factors. The aim of our study is to determine the prevalence and factors associated with Gastric atrophy and intestinal metaplasia in patients infected with Helicobacter pylori. Methods: This is a prospective study over a period of 4 years (May 2009 - January 2015) conducted in the service of Hepatology and Gastroenterology in hospital university Hassan II of Fez in collaboration with microbiology and molecular biology laboratory and epidemiology service of Faculty of Medicine and Pharmacy Fes. We included in our study all patients aged over 15 years, having ulcerative dyspepsia, peptic ulcer disease, gastritis or esophagitis. Results: During the study period, 1190 patients were included of which 70% had HP infection (N = 833). The average age was 48.21 years [16 - 99 years], sex ratio M/F was 1, 11. 60% of patients were older than 45 years. Chronic smoking was found in 12% of patients. Gastric atrophy was observed in 84% (N = 699) of patients infected with HP. Gastric atrophy was localized in 70% in the antrum and 30% in the fundus and 24% in both. The activity of gastritis (p = 0.0001) and the density of the HP (p = 0.005) were factors associated with atrophy. intestinal metaplasia was observed in 13.5% of patients (N = 112). The density of HP (p = 0.037) and severe atrophy (p = 0.001) were factors associated with metaplasia. Other factors studied: age, sex, smoking, CagA+ genotype were not associated with either gastric atrophy or intestinal metaplasia. Conclusion: In our study, the prevalence of atrophic gastritis and intestinal metaplasia in patients infected with Helicobacter pylori was 84% and 13.5% respectively, which was a high prevalence. The activity of gastritis, and density of HP were factors associated with atrophy. The density of HP and severe

关键词： Gastric Atrophy intestinal metaplasia Helicobacter pylori Gastritis

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Gastric-and-intestinal Mixed intestinal metaplasia Is Irreversible Point with Eradication of Helicobacter pylori

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Open Journal of Pathology 2016年第2期6卷 93-104页

作者： Yuka Kiriyama Tomomitsu Tahara Tomoyuki Shibata Masaaki Okubo Mitsuru Nakagawa Asako Okabe Naoki Ohmiya Makoto Kuroda Atsushi Sugioka Masao Ichinose Masae Tatematsu Tetsuya Tsukamoto Department of Diagnostic Pathology School of Medicine Fujita Health University Toyoake Aichi Japan Department of Gastroenterology School of Medicine Fujita Health University Toyoake Aichi Japan Department of Hepatobiliary and Liver Transplant Surgery School of Medicine Fujita Health University Toyoake Japan Second Department of Internal Medicine Wakayama Medical University Wakayama Japan Japan Bioassay Research Center Hadano Japan

Helicobacter pylori (H. pylori) represents an important factor in the development of atrophic gastritis, intestinal metaplasia (IM), and gastric cancer. Eradication of H. pylori has been reported to prevent gastric cancer only in cases without atrophy or IM. However, histological changes with eradication have yet to be fully clarified. We evaluated 38 H. pylori-positive cases before and after eradication at the gland level;pyloric glands were classified as showing gastric proper (G) and IM gland types, with the latter including gastric-and-intestinal mixed IM (GI-IM) and solely intestinal IM (I-IM), depending on the remaining gastric phenotypes. On eradication, acute and chronic inflammation attenuated rapidly and gradually, respectively, whereas levels of MUC5AC and MUC6 expression were not markedly altered. Gland width, size of nuclei and cytoplasm and their ratio in surface foveolar epithelium, the number of Ki-67-positive cells and the length of the proliferating zone in each gland were significantly decreased in G glands after eradication compared with those in GI-IM and I-IM. The number of mitotic phase cells, positive for phosphorylated histone H3 at serine 28, was increased in both types of IM compared to that in G glands in the H. pylori-infected state, but unexpectedly remained unchanged with eradication. These results suggest that GI-IM, as the beginning of IM, could represent a histological irreversible point with eradication and be considered as a “histological point of no return”.

关键词： Helicobacter pylori Chronic Atrophic Gastritis intestinal metaplasia Eradication Stomach

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