Document Detail

Chronic gastritis, intestinal metaplasia, dysplasia and Helicobacter pylori in gastric cancer: putting the pieces together.
MedLine Citation:
PMID:  7599347     Owner:  NLM     Status:  MEDLINE    
Chronic gastritis may favour the development of gastric cancer more as a condition than as precancerous lesion. Since, in most cases, it is pathologically correlated with Helicobacter pylori infection, it is reasonable to postulate at least an indirect role for this organism in the pathogenesis of gastric cancer. H. pylori, however, is only one of the risk factors involved, in that additional factors (excess salt, cigarette smoking, deficiency of foodstuffs with an antioxidizing effect) may facilitate the malignant transformation of chronic atrophic gastritis into intestinal-type gastric cancer. Gastric carcinogenesis therefore presents itself as a multifactorial, multistage process, furthered by the occurrence of precancerous lesions which are usually interrelated (type-III intestinal metaplasia, severe dysplasia) and by functional alterations such as achlorhydria, which, though it is not enough in itself to cause gastric cancer, promotes abnormal intragastric bacterial development, a condition which may be followed by abnormal intragastric formation of cancerogenous nitroso compounds. The existence of a close correlation between both gastric cancer and H. pylori infection and low socio-economic and hygienic status of the population lends further strength to the hypothesis that an "H. pylori factor" is involved in gastric carcinogenesis. Consequently, to reduce the risk of gastric cancer, various strategies have been devised to prevent H. pylori infection (improvement in socio-environmental conditions, anti-H. pylori vaccine) and/or to eradicate the organism (by means of therapeutic regimens including antimicrobial agents, which, however, can be implemented only in patients who have not developed diffuse atrophy and/or dysplasia, in whom H. pylori may no longer be detectable). Definitive proof of the real extent of the relationship between H. pylori and gastric cancer and of the efficacy of therapeutic and preventive measures can be provided only by controlled trials in populations with a high prevalence of chronic non-atrophic gastritis which are difficult to organize.
G Dobrilla; S Benvenuti; S Amplatz; L Zancanella
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Italian journal of gastroenterology     Volume:  26     ISSN:  0392-0623     ISO Abbreviation:  Ital J Gastroenterol     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-08-10     Completed Date:  1995-08-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8000544     Medline TA:  Ital J Gastroenterol     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  449-58     Citation Subset:  IM    
Divisione di Gastroenterologia, Ospedale Generale Regionale, Bolzano, Italy.
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MeSH Terms
Chronic Disease
Gastritis / complications*,  pathology
Helicobacter Infections / complications*,  microbiology,  pathology
Helicobacter pylori / isolation & purification*
Intestinal Diseases / complications,  pathology*
Stomach Neoplasms / etiology*,  microbiology,  pathology

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