Screening for stomach cancer in atrophic gastritis

Chronic gastritis is the most common disease of the digestive system, characterized by persistent inflammation and impaired cellular renewal with the development of atrophy and intestinal metaplasia. Long-term H. pylori-associated and autoimmune gastritis is the main cause of the development of gastric mucosal atrophy and subsequent gastric cancer. Regardless of the mechanism of atrophy development (damage to the proliferative compartment and destruction of glands through direct bacterial action and inflammatory response or mediated by autoimmune reactions causing the destruction of glandular epithelial cells with preservation of stem cells)It is necessary to determine the severity and extent of atrophic gastritis. This requires modern electronic endoscopy with the ability to use high-resolution modes and image magnification, taking a biopsy from five points with subsequent histopathological staging, which should include topography, the degree of atrophic changes, as well as the stage, which determines the scope and frequency of dynamic observation of the patient. Leading domestic and international gastroenterology organizations recommend that patients with stage III–IV atrophy undergo endoscopic monitoring using expert-class equipment once every three years, and in the presence of a family history of stomach cancer, every year.