Morphology and Diagnostic Determinants of Gastric Precancerous Conditions

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Sergio Sotelo & Carlos Manterola


Gastric carcinoma (GC) of intestinal type, originates from a dysplastic epithelium, which in turn develops in the midst of gastric atrophy (GA) and intestinal metaplasia (IM). Helicobacter pylori (HP) infection is the most frequent cause of GA, causing a multifocal atrophic pangastritis. Among other conditions that produce chronic inflammation of gastric mucosa are also autoimmune gastritis and pernicious anemia. The conceptual framework on which much of current research rests and our understanding of the changes that occur in the gastric mucosa is due to the so-called "Correa waterfall"; who stated that gastric mu- cosa chronically inflamed, gives way to the GA, which is acquiring foci of IM and in said epithelium a dysplasia (DIS) will eventually develop. The term precancerous conditions (PCC) of the gastric mucosa have been coined to refer to: GA, IM and DIS. After HP eradication, a general reduction in the incidence of GC has been demonstrated; effect that is not so clear, when pangastritis by HP has evolved to extensive GA. Thus, the effect of HP eradication measured through clinical trials has been inconsistent. Severe GA diagnosed represents the highest risk condition. On the other hand, IM can be enteric (grade I), enterocolic (grade II) or colonic (grade III); considering IM III as the variety with the worst prognosis. Histological diagnosis of gastric PCC, determines that the one who suffers them, must undergo endoscopic surveillance. The aim of this manuscript was to update morphological aspects and diagnostic-therapeutic scope of gastric PCC.

KEY WORD: "Precancerous Conditions"[Mesh]; "Stomach Neoplasms"[Mesh]; "Helicobacter pylori"[Mesh]; Gastric precancerous conditions; "Gastritis, Atrophic"[Mesh]; Gastritis chronic active non atrophic; Gastritis atrophic multifocal; "Metaplasia"[Mesh]; Intestinal metaplasia; Gastric dysplasia.

How to cite this article

SOTELO, S. & MANTEROLA, C. Morphology and diagnostic determinants of gastric precancerous conditions. Int. J. Morphol., 37(3)917-927, 2019.