Bogdanova I, Polaka I, Aleksandraviča I, Dzērve Z, Anarkulova L, Novika V, Tolmanis I, Leja M. Role of pre-existing incomplete intestinal metaplasia in gastric adenocarcinoma: A retrospective case series analysis. World J Clin Cases 2023; 11(12): 2708-2715 [PMID: 37214563 DOI: 10.12998/wjcc.v11.i12.2708]
Corresponding Author of This Article
Marcis Leja, AGAF, MD, PhD, Academic Editor, Director, Professor, Researcher, Institute of Clinical and Preventive Medicine, University of Latvia, 1 Gaiļezera Iela, Riga LV1079, Latvia. marcis.leja@lu.lv
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 26, 2023; 11(12): 2708-2715 Published online Apr 26, 2023. doi: 10.12998/wjcc.v11.i12.2708
Role of pre-existing incomplete intestinal metaplasia in gastric adenocarcinoma: A retrospective case series analysis
Inga Bogdanova, Inese Polaka, Ilona Aleksandraviča, Zane Dzērve, Linda Anarkulova, Vita Novika, Ivars Tolmanis, Marcis Leja
Inga Bogdanova, Department of Pathology, Academic Histology Laboratory, Riga LV1073, Latvia
Inga Bogdanova, Inese Polaka, Ilona Aleksandraviča, Zane Dzērve, Linda Anarkulova, Marcis Leja, Institute of Clinical and Preventive Medicine, University of Latvia, Riga LV1079, Latvia
Ilona Aleksandraviča, Marcis Leja, Department of Research, Riga East University Hospital, Riga LV1079, Latvia
Zane Dzērve, Vita Novika, Ivars Tolmanis, Department of Endoscopy, Digestive Diseases Centre GASTRO, Riga LV1079, Latvia
Marcis Leja, Department of Gastroenterology, Digestive Diseases Centre GASTRO, Riga LV1079, Latvia
Author contributions: Bogdanova I designed the outline and performed all the pathology evaluation, including specific staining for intestinal metaplasia subtypes, performed the analysis of the obtained results and design of the tables; Aleksandraviča I coordinated the biobanking activities and data acquisition; Tolmanis I reviewed the endoscopy reports; Leja M coordinated the research and participated in the outline design and writing of the paper, all authors were involved in writing and final approval of the manuscript.
Institutional review board statement: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Medical and Biomedical Research Ethics Committee of the Riga East University Hospital Support Foundation, protocol 18-A/16, October 6, 2016.
Informed consent statement: Signed consent was obtained form all the study subjects at the time of their recruitment to the Biobank.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other co-authors contributed their efforts in this manuscript.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marcis Leja, AGAF, MD, PhD, Academic Editor, Director, Professor, Researcher, Institute of Clinical and Preventive Medicine, University of Latvia, 1 Gaiļezera Iela, Riga LV1079, Latvia. marcis.leja@lu.lv
Received: December 27, 2022 Peer-review started: December 27, 2022 First decision: January 5, 2023 Revised: January 19, 2023 Accepted: March 29, 2023 Article in press: March 29, 2023 Published online: April 26, 2023 Processing time: 119 Days and 5.1 Hours
Abstract
BACKGROUND
Risk stratification for patients with gastric precancerous lesions for endoscopic surveillance remains controversial.
AIM
To analysis of patients having developed gastric adenocarcinoma during the period of follow-up.
METHODS
We conducted a retrospective study on patients having undergone upper endoscopy prior to the development of gastric adenocarcinoma. The presence and stage of precancerous lesions as well as subtype of intestinal metaplasia at the baseline endoscopy got evaluated. Literature mini-review was performed.
RESULTS
Out of 1681 subjects in the Biobank, gastric adenocarcinoma was detected in five cases in whom previous endoscopy data with biopsies either from the corpus or antral part were available. All of the patients had incomplete intestinal metaplasia during the baseline endoscopy; all three subjects in whom intestinal metaplasia subtyping was performed according to Filipe et al, had Type III intestinal metaplasia. Two of the five cases had low Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis Intestinal Metaplasia Assessment (OLGIM) stages (I-II) at the baseline.
CONCLUSION
The presence of incomplete intestinal metaplasia, in particular, that of Type III is a better predictor for gastric adenocarcinoma development than OLGA/OLGIM staging system. Subtyping of intestinal metaplasia have an important role in the risk stratification for surveillance decisions.
Core Tip: We present a retrospective case series and analysis of the available literature evidence on gastric mucosal precancerous lesion characteristics preceding gastric adenocarcinoma development. The obtained data are strongly suggesting that subtyping of gastric intestinal metaplasia, in particular that of Type III is an important predictor for the development of adenocarcinoma. The subtype of intestinal metaplasia appears to be a better predictor for cancer than Operative Link on Gastritis Assessment and Operative Link on Gastritis Intestinal Metaplasia Assessment staging system, however larger studies would be required to confirm this.
