Atrophic gastritis, the disease’s name, literally means a smaller stomach. Actually, this is a misunderstanding. Atrophy, the word, is not an anatomical description, but a pathological change. Specifically, gastric mucosal epithelium and glands atrophy, decrease in number, mucosal thinning, and at the same time, the base layer thickens. Chronic atrophic gastritis is detected in about 7.5% to 13.8% of people undergoing gastroscopy. So, can atrophic gastritis be reversed? Will it develop into stomach cancer? Let’s break down the relevant points now.
From the perspective of the development process of gastric cancer, the changes of gastric mucosa, usually, chronic superficial gastritis occurs first, then progresses to chronic atrophic gastritis, then, intestinal metaplasia, and intraepithelial neoplasia occur, and finally, cancer is formed . Atrophy, intestinal metaplasia, and intraepithelial neoplasia are all precancerous lesions. In the latest guidelines, high-grade intraepithelial neoplasia has been classified as early-stage cancer. Intestinal gland metaplasia, referred to as intestinal metaplasia, is a site that should belong to the gastric mucosa, and the intestinal mucosa appears. Observed under a gastroscope, it appears as a gray-white bulge of the gastric antrum. Intraepithelial neoplasia, also known as dysplasia, is a change in the epithelial cells of the gastric mucosa, which is the initial stage of tumor growth and can be divided into different grades. Severe dysplasia has a higher risk of developing gastric cancer in the short term. Intestinal metaplasia and intraepithelial neoplasia are diagnosed by taking out biopsy tissue during gastroscopy and performing pathological examination.
According to previous knowledge, after the formation of atrophic gastritis, the atrophic glands at the lesion site cannot be recovered, so the condition cannot be reversed. However, studies in recent years have shown that chronic atrophic gastritis, as long as it is detected in time and treated early, the glands can be recovered and transformed into superficial gastritis or cured. Therefore, the condition of atrophic gastritis can be reversed.
Atrophic gastritis, if the treatment is not timely or ineffective, there is a risk of cancer. It is generally believed that within 5 to 10 years, the cancer rate is about 3% to 5%. More than 10 years, the cancer rate exceeds 10%. In terms of pathological classification, mild dysplasia has a 10-year cancer rate of 2.5% to 11%, moderate dysplasia has a 10-year cancer rate of 4% to 35%, and severe dysplasia has a 10-year cancer rate of 10%. % to 83%. Among them, patients with severe intestinal metaplasia, severe dysplasia, and carcinoembryonic antigen-positive patients have higher cancer rates.
To prevent atrophic gastritis from developing into gastric cancer, four measures need to be taken. The first item is regular review, because the pathological changes of the gastric mucosa are gradually formed. By understanding the situation of dysplasia, the risk of cancer can be more accurately assessed. It is recommended that patients without intestinal metaplasia or dysplasia should undergo gastroscopy and pathological follow-up every 1 to 2 years. Moderate or severe atrophy, or those with intestinal metaplasia, should be followed up at least once a year. Mild dysplasia, every 6 months, follow-up examination 1 time. In severe dysplasia, biopsy and pathological examination should be done immediately.
The second measure is to remove precancerous lesions. For high-grade intraepithelial neoplasias such as severe dysplasia, endoscopic resection should be performed. Even some early gastric cancers can be radically cured by endoscopic minimally invasive methods. The third measure is to eradicate Helicobacter pylori, because the cytotoxic factors produced by Helicobacter pylori can cause atrophic gastritis in the gastric mucosa and increase the risk of gastric cancer by 3 to 6 times. Radical treatment of Helicobacter pylori is beneficial to alleviate the progression of precancerous lesions, thereby reducing the risk of gastric cancer.
The fourth measure to prevent atrophic gastritis from carcinogenesis and to achieve reversal of the disease is to change living habits. For example, chew slowly, stimulate the stimulation of rough food on the gastric mucosa, eat in moderation, avoid overeating, pay attention to dietary hygiene, quit smoking and limit alcohol, and do not drink strong tea. Properly increasing the intake of vegetables and fruits, supplementing vitamin C and folic acid, can reduce the synthesis of nitrosamine compounds, maintain DNA methylation, and inhibit the activation of cancer genes. In addition, appropriately increasing the intake of fish, shrimp, garlic, mushrooms and other foods, and supplementing with selenium can help to scavenge free radicals, enhance immune function, and reduce the risk of cancer.
Whoever you love, pass on your health to whoever you love.