title: Secondary prevention of epidemic gastric cancer in the model of Helicobacter pylori-associated gastritis.
abstract: Irrespective of its etiology, long-standing, non-self-limiting gastric inflammation (mostly in Helicobacter pylori-associated cases) is the cancerization ground on which epidemic (intestinal-type) gastric carcinoma (GC) can develop. The natural history of invasive gastric adenocarcinoma encompasses gastritis, atrophic mucosal changes, and intraepithelial neoplasia (IEN). The topography, the extent and the severity of the atrophic changes significantly correlate with the risk of developing both IEN and GC. In recent years, both noninvasive (serological) tests and invasive (endoscopy/biopsy) procedures have been proposed to stratify patients according to different classes of GC risk. As a consequence, different patient-tailored GC secondary prevention strategies have been put forward. This review summarizes the histological features of H. pylori-related gastritis and the natural history of the disease. Histological and serological strategies to assess GC risk as well as the clinical management of atrophic gastritis patients are also discussed.
authors.affiliation: General Pathology and Cytopathology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pizzi
authors.forename: Deborah
authors.initials: D
authors.lastname: Saraggi
authors.forename: Matteo
authors.initials: M
authors.lastname: Fassan
authors.forename: Francis
authors.initials: F
authors.lastname: Megraud
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Mario
authors.forename: Massimo
authors.initials: M
authors.lastname: Rugge
mesh_terms: D063646:Carcinogenesis / Q000473:pathology; D005756:Gastritis / Q000097:blood / Q000150:complications / Q000382:microbiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000502:physiology*; D006801:Humans; D008954:Models, Biological; D055502:Secondary Prevention; D013274:Stomach Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control