Skip to main content

Advertisement

SpringerLink
Log in

Prevalence of Gastric Preneoplastic Lesions in First-Degree Relatives of Patients with Gastric Cancer: a Cross-Sectional Study

  • Original Research
  • Published:
Journal of Gastrointestinal Cancer Aims and scope Submit manuscript

Abstract

Purpose

Worldwide, gastric cancer (GC) is the 5th cancer with the highest incidence and the 4th in mortality. To reduce it, one strategy is to diagnose preneoplastic lesions (PNL): atrophic gastritis (AG), intestinal metaplasia (IM), and dysplasia (DYS); to form risk groups on which to focus surveillance efforts as are first-degree relatives (FDR). The aim of this study was to determine prevalence of gastric PNL in FDR of patients with GC, and to study association with sex, age, and Helicobacter pylorii (Hp) infection.

Methods

Cross-sectional study. One hundred and ten FDR, aged between 50 and 65 years, 54.5 female, obtained through convenience sampling, were studied. Biodemographic data survey and upper gastrointestinal endoscopy with histological study were applied according to Sidney protocol, and focal lesions found. Diagnosis of these lesions and condition of mucosa was carried out by applying OLGA and OLGIM systems. Descriptive statistics, estimation of prevalence, odds ratio (OR), and 95% confidence intervals (95CI) were calculated.

Results

Median age of study group was 56.5 years. Prevalence of PNL, AG, IM, and DYS were 86.4%, 82.7%, 54.5%, and 12.7% respectively. Advanced stages of OLGA and OLGIM were verified in 18.0% and 16.3% respectively. No association with sex, age, and Hp infection were found ([OR 3.10; 95CI 1.0; 9.64]; [OR 0.74; 95CI 0.26; 2.14]; [OR 0.58; 95CI 0.12; 2.77]) respectively.

Conclusion

FDR of patients with GC have a high prevalence of PNL, which makes them a risk group in which endoscopic surveillance should be applied.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data Availability

All data generated or analyzed during this study are included in this article or its supplementary material files. Further enquiries can be directed to the corresponding author.

Abbreviations

GC:

Gastric cancer

PNL:

Preneoplastic lesions

AG:

Atrophic gastritis

IM:

Intestinal metaplasia

DIS:

Displasia

Hp :

Helicobacter pylorii

FDR:

First -degree relatives

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: Cancer J Clin. 2018;68(6):394–424.

    PubMed  Google Scholar 

  2. MINSAL.Guía Clínicas AUGE. Cáncer Gástrico. 2014. Available from: https://www.IMnsal.cl/sites/default/files/files/GPC%20G%C3%A1strico%20(PL).pdf. Accessed 30 Jul 2021.

  3. World Health Organization. Internal Agency for Research Cancer. Global Cancer Observatory: Cancer Today. Cancer incidence and mortality data. 2020. https://gco.iarc.fr/today. Accessed 18 Jul 2021.

  4. Csendes A, Figueroa M. Situation of gastric cancer in the world and in Chile. Rev Chil Cir. 2017;69(6):502–7.

    Article  Google Scholar 

  5. Lauren P. The two histological main types of gastric. Carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histoclinical classification. Acta Pathol IMcrobiol Scand. 1965;64:31–49.

  6. Muller B, de la Fuente H, Barajas O, CardeIMl B, Vila A, Mordojovich E, et al. Gastric cancer treatment evaluation registry in Chile (REGATE): baseline clinical characteristics of 523 patients. Rev Chil Cir. 2011;63(2):147–53.

    Article  Google Scholar 

  7. Khanderia E, Markar SR, Acharya A, Kim Y, Kim YW, Hanna GB. The influence of gastric cancer screening on the stage at diagnosis and survival: a meta-analysis of comparative studies in the Far East. J Clin Gastroenterol. 2016;50(3):190–7.

    Article  PubMed  Google Scholar 

  8. Kim YG, Kong SH, Oh SY, Lee KG, Suh YS, Yang JY, et al. Effects of screening on gastric cancer management: comparative analysis of the results in 2006 and in 2011. J Gastric Cancer. 2014;14(2):129–34.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Sjomina O, Pavlova J, Daugule I, Janovic P, Kikuste I, Vanags A, et al. Pepsinogen test for the evaluation of precancerous changes in gastric mucosa: a population-based Study. J Gastrointestin Liver Dis. 2018;27(1):11–7.

    Article  PubMed  Google Scholar 

  10. Rollán A, Cortés P, Calvo A, Araya R, Bufadel ME, González R, et al. Recommendations of the Chilean Association for Digestive Endoscopy for the management of gastric pre-malignant lesions. Revista Medica de Chile. 2014;142(9):1181–92.

    Article  PubMed  Google Scholar 

  11. Choi IJ. Endoscopic gastric cancer screening and surveillance in high-risk groups. Clin Endosc. 2014;47(6):497–503.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Pimentel-Nunes P, Libânio D, Marcos-Pinto R, Areia M, Leja M, Esposito G, et al. Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopía Digestiva (SPED) guideline update 2019. Endoscopy. 2019;51(4):365–88.

    Article  PubMed  Google Scholar 

  13. Correa P, Haenszel W, Cuello C, Tannenbaum S, Archer M. A model for gastric cancer epidemiology. Lancet. 1975;2(7924):58–60.

    Article  CAS  PubMed  Google Scholar 

  14. Correa P, Piazuelo MB. The gastric precancerous cascade. J Dig Dis. 2012;13(1):2–9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process – First American Cancer Society Award lecture on cancer epidemiology and prevention. Cancer Res. 1992;52(24):6735–40.

    CAS  PubMed  Google Scholar 

  16. Correa P. A human model of gastric carcinogenesis. Cancer Res. 1998;48(13):3554–60.

    Google Scholar 

  17. Sampieri CL. Helicobacter pylori and gastritis: the role of extracellular matrix metalloproteases, their inhibitors, and the disintegrins and metalloproteases–a systematic literature review. Dig Dis Sci. 2013;58(10):2777–83.

    Article  CAS  PubMed  Google Scholar 

  18. Yakirevich E, Resnick MB. Pathology of gastric cancer and its precursor lesions. Gastroenterol Clin North Am. 2013;42(2):261–84.

    Article  PubMed  Google Scholar 

  19. Abangah G, Rahmani A, Hafezi-Ahmadi MR, EmaIM T, Asadollahi K, Jaafari-Haidarlo A, Moradkhani A. Precancerous histopathologic lesions of upper gastrointestinal tract among dyspeptic patients upon endoscopic evaluations. J Gastrointest Cancer. 2016;47(1):1–7.

    PubMed  Google Scholar 

  20. Li D, Bautista MC, Jiang SF, Daryani P, Brackett M, Armstrong MA, et al. Risks and predictors of gastric adenocarcinoma in patients with gastric intestinal metaplasia and dysplasia: a population-based study. Am J Gastroenterol. 2016;111(8):1104–13.

    Article  PubMed  Google Scholar 

  21. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Ann Intern Med. 2007;147(8):573–7.

    Article  Google Scholar 

  22. Rugge M, Correa P, Di Mario F, El-Omar E, Fiocca R, Geboes K, et al. OLGA staging for gastritis: a tutorial. Dig Liver Dis. 2008;40(8):650–8.

    Article  CAS  PubMed  Google Scholar 

  23. Capelle LG, de Vries AC, Haringsma J, Ter Borg F, de Vries RA, Bruno MJ, et al. The staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis. Gastrointest Endosc. 2010;71(7):1150–8.

    Article  PubMed  Google Scholar 

  24. Marcos-Pinto R, Carneiro F, Dinis-Ribeiro M, Wen X, Lopes C, Figueiredo C, et al. First-degree relatives of patients with early-onset gastric carcinoma show even at young ages a high prevalence of advanced OLGA/OLGIM stages and dysplasia. Aliment Pharmacol Ther. 2012;35(12):1451–9.

    Article  CAS  PubMed  Google Scholar 

  25. Isajevs S, Liepniece-Karele I, Janciauskas D, Moisejevs G, Putnins V, Funka K, et al. Gastritis staging: interobserver agreement by applying OLGA and OLGIM systems. Virchows Archiv. 2014;464(4):403–7.

    Article  PubMed  Google Scholar 

  26. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol. 1996;20(10):1161–81.

  27. World Medical Association. Declaration of Helsinki-Ethical Principles for Medical Research involving Human Subjects. 2013.  https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects. Accessed 2 Aug 2021.

  28. Negovan A, Iancu M, Moldovan V, Pantea M, Sarkany K, Bataga S, et al. Influence of MDR1 C3435T, CYP2C19*2 and CYP2C19*3 gene polymorphisms and clinical characteristics on the severity of gastric lesions: a case-control study. J Gastrointestin Liver Dis. 2016;25(2):258–60.

    PubMed  Google Scholar 

  29. Negovan A, Lancu M, Fülöp E, Bănescu C. Helicobacter pylori and cytokine gene variants as predictors of premalignant gastric lesions. World J Gastroenterol. 2019;25(30):4105–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Olmez S, Aslan M, Erten R, Sayar S, Bayram I. The prevalence of gastric intestinal metaplasia and distribution of Helicobacter pylori infection, atrophy, dysplasia, and cancer in its subtypes. Gastroenterol Res Pract. 2015;2015.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Sonnenberg A, Lash RH, Genta RM. A national study of Helicobactor pylori infection in gastric biopsy specimens. Gastroenterology. 2010;139(6):1894-1901.e2.

    Article  PubMed  Google Scholar 

  32. Latorre SG, Jiménez BM, Robles GC, Jensen E, Ramos B, Fritzsche M, et al. Increased detection of premalignant gastric lesions through Sidney protocol in comparison with non-protocolized gastric biopsies. Gastroenterol Latinoam. 2016;27(4):207–14.

    Google Scholar 

  33. Bellolio E, Riquelme I, Riffo-Campos A, Rueda C, Ferreccio C, Villaseca M, et al. Assessment of gastritis and gastric cancer risk in the Chilean population using the OLGA system. Pathol Oncol Res. 2019;25(3):1135–42.

    Article  CAS  PubMed  Google Scholar 

  34. Marcos-Pinto R, Dinis-Ribeiro M, Carneiro F, Machado JC, Figueiredo C, Reis CA, et al. First degree relatives and familial aggregation of gastric cancer: who to choose for control in case-control studies? Familial Cancer. 2012;11(1):137–43.

    Article  PubMed  Google Scholar 

  35. Filomen A, Saieva C, Lucchetti V, Santacroce F, Falorni P, Francini V, et al. Gastric cancer surveillance in a high-risk population in tuscany (Central Italy): preliminary results. Digestion. 2011;84(1):70–7.

    Article  Google Scholar 

  36. Gómez Zuleta M, Garzón Nossa D, Otero RW. First-degree relatives of patients with gastric cancer have high frequencies of achlorydria and premalignant gastric lesions. Rev Col Gastroenterol. 2014;29(1):3–10.

    Google Scholar 

  37. Figueroa G, Acuña R, Troncoso M, Portell D, Toledo S, Valenzuela J. Helicobacter pylori infection in Chile. Clin Infect Dis. 1997;25(5):983–9.

    Article  CAS  PubMed  Google Scholar 

  38. Araya JC, Villaseca MA, Roa I, Roa JC. Helicobacter pylori and chronic gastritis: relationship between infection and inflammatory activity in a high-risk population for gastric cancer. Revista Medica de Chile. 2000;128(3):259–66.

    CAS  PubMed  Google Scholar 

  39. Ferreccio C, Rollán A, Harris PR, Serrano C, Gederlini A, Margozzini P, et al. Gastric cancer is related to early helicobacter pylori infection in a high-prevalence country. Cancer Epidemiol Biomarkers Prev. 2007;16(4):662–7.

    Article  CAS  PubMed  Google Scholar 

  40. Manterola C, Otzen T. Biases in clinical research. Int J Morphol. 2015;33(3):1156–64.

    Article  Google Scholar 

  41. Sotelo S, Manterola C. Morphology and diagnostic-therapeutic repercussions of gastric preneoplastic lesions. Int J Morphol. 2019;37(3):917–27.

    Article  Google Scholar 

  42. Dinis-Ribeiro M, Areia M, de Vries AC, Marcos-Pinto R, Monteiro-Soares M, O’Connor A, et al. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED). Endoscopy. 2012;44(1):74–94.

    Article  CAS  PubMed  Google Scholar 

  43. Yaghoobi M, Bijarchi R, Narod SA. Family history and the risk of gastric cancer. Br J Cancer. 2010;102(2):237–42.

    Article  CAS  PubMed  Google Scholar 

  44. Song H, Ekheden IG, Ploner A, Ericsson J, Nyren O, Ye W. Family history of gastric mucosal abnormality and the risk of gastric cancer: a population-based observational study. Int J Epidemiol. 2018;47(2):440–9.

    Article  PubMed  Google Scholar 

  45. Dhillon PK, Farrow DC, Vaughan TL, Chow WH, Risch HA, Gammon MD, et al. Famiy history of cancer and risk of esophageal and gastric cancers in the United States. Int J Cancer. 2001;93(1):148–52.

    Article  CAS  PubMed  Google Scholar 

  46. García-González MA, Lanas A, Quintero E, Nicolás D, Parra-Blanco A, Strunk M, et al. Gastric cancer susceptibility is not linked to pro-and anti-inflammatory cyto- kine gene polymorphisms in whites: a Nationwide Multicenter Study in Spain. Am J Gastroenterol. 2007;102(9):1878–92.

    Article  PubMed  Google Scholar 

  47. Akir T, Can G, Erkul S, Siviloglu C. Stomach cancer history in the siblings of patients with gastric carcinoma. Eur J Cancer Prev. 2000;9(6):401–8.

    Article  Google Scholar 

  48. El-Omar EM, Oien K, Murray LS, El-NujuIM A, Wirz A, Gillen D, et al. Increased prevalence of precancerous changes in relatives of gastric cancer patients: critical role of H. pylori. Gastroenterology. 2000;118(1):22–30.

  49. Rokkas T, Sechopoulos P, Pistiolas D, Margantinis G, Koukoulis G. Helicobacter pylori infection and gastric histology in first-degree relatives of gastric cancer patients: a meta-analysis. Eur J Gastroenterol Hepatol. 2010;22(9):1128–33.

    Article  PubMed  Google Scholar 

  50. You WC, Ma JL, Liu WD, Gail MH, Chang YS, Zhang L, et al. Blood type and family cancer history in relation to precancerous gastric lesions. Int J Epidemiol. 2000;29(3):405–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This work was partially supported by Project MEC 80170022, CONICYT Chile 2018. The funding body collaborated in the design of the study and interpretation of data and in writing the manuscript.

Author information

Authors and Affiliations

  1. PhD Program in Medical Sciences, Universidad de La Frontera, Temuco, Chile

    Sergio Sotelo

  2. Faculty of Medicine, Universidad Católica del Maule, Talca, Chile

    Sergio Sotelo, Erik Morales & Iván Castillo

  3. Hospital Regional de Talca, Talca, Chile

    Sergio Sotelo, Erik Morales & Iván Castillo

  4. Center of Morphological and Surgical Studies (CEMyQ), and PhD Program in Medical Sciences, and Millennium Nucleus on Sociomedicine, Universidad de La Frontera, Manuel Montt 115, 54-D, Temuco, Chile

    Carlos Manterola & Tamara Otzen

Authors
  1. Sergio Sotelo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carlos Manterola
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tamara Otzen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Erik Morales
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Iván Castillo
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SS and CM: made substantial contributions to the conception, design, analysis, interpretation of data. Both have drafted the work and approved the submitted version. TO, EM and IC: made substantial contributions to the design, analysis, interpretation of data, and approved the submitted version.

Corresponding author

Correspondence to Carlos Manterola.

Ethics declarations

Ethics Approval and Consent to Participate

Subjects gave their written informed consent. This study protocol was reviewed and approved by Servicio de Salud del Maule Scientific Ethical Committee and approved in September 2018 (Code 046–0918).

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sotelo, S., Manterola, C., Otzen, T. et al. Prevalence of Gastric Preneoplastic Lesions in First-Degree Relatives of Patients with Gastric Cancer: a Cross-Sectional Study. J Gastrointest Canc 54, 513–519 (2023). https://doi.org/10.1007/s12029-022-00827-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12029-022-00827-x

Keywords

Search

Navigation