Endoscopic markers predicting high risk of gastric cancer in patients with chronic gastritis

Introduction. Changes in the gastric mucosa associated with Helicobacter pylori infection, determined during endoscopic examination, can serve as indicators of an increased risk of developing gastric cancer. 
Study objective. To detect endoscopic predictors of gastric cancer in patients with chronic gastritis.
Materials and methods. A retrospective pilot case-control study included 32 patients with gastric adenocarcinoma. The comparison group included 80 patients with chronic H. pylori-associated gastritis. The study included patients with early and localized forms of gastric cancer. The study was conducted at the Federal State Budgetary Educational Institution of Additional Professional Education RMANPO. Patients were examined and treated from September 2020 to January 2025 at Medsi in Otradnoye Clinical Hospital, MEDSI on Krasnaya Presnya Clinical and Diagnostic Center of MEDSI Group of Companies, the V. V. Veresaev City Clinical Hospital, and the Endoscopy Center of the S. P. Botkin Medical Scientific and Clinical Center.
Results. Statistically significant differences were obtained for the following predictors: severe atrophy OR = 2,833 (95 % CI: 1,193–6,724); intestinal metaplasia OR = 11,400 (95 % CI: 3,318–39,164), hyperplasia of the gastric folds OR=2,833 95 % (CI: 1,193–6,724), gastric xanthoma OR = 6,333 (95 % CI: 1,752–22,892). The resulting model that determined the probability of neoplasm depending on intestinal metaplasia, enlarged folds and xanthoma has a sensitivity and specificity of 80,6 % and 67,5 %, respectively, PPV 71,3 % and NPV 77,7 %. Conclusion. The study identified additional predictors of gastric cancer: enlarged folds and xanthoma, in addition to the traditionally used atrophy and intestinal metaplasia of the mucosa.

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