Ultrasound criteria for predicting pre-cancer changes of the gastric mucosa in patients with chronic atrophic gastritis combined with thyroid pathology

Authors

DOI:

https://doi.org/10.14739/2310-1210.2022.3.252716

Keywords:

atrophic gastritis, metaplasia, dysplasia, precancerous conditions, ultrasonography

Abstract

Precancerous conditions increase the risk of gastric cancer by 2–3 % every 10 years. Among comorbid pathology, 46 % of all endocrinopathies are diseases of the thyroid gland. An urgent issue today is the definition of non-invasive criteria for the formation of a risk group for the detection of precancerous changes in the gastric mucosa in patients with comorbid pathology.

The aim of the study was to evaluate the structure of the thyroid gland as ultrasound criterion for predicting precancerous lesions in the stomach in patients with atrophic gastritis under conditions of comorbidity.

Materials and methods. The study was conducted among 81 patients with gastric precancerous conditions. The upper endoscopy was performed using EVIS EXERA III systems with an Olympus 190 gastroscope (Japan). All the patients in this study underwent a sonological examination of the thyroid gland on an ultrasound scanner Toshiba Xario (Japan).

Results. In patients with atrophic gastritis, a high frequency of structural changes in the thyroid gland (77 %) was observed. Focal changes were determined in 33 % of atrophic gastritis patients with a predominance of their diagnostic frequency in patients with gastric mucosal dysplasia (χ2 = 5.32, P < 0.05 as compared to the patients with gastric mucosal atrophy and χ2 = 4.25, P < 0.05 as compared to the patients from the intestinal metaplasia group).

Patients with gastric mucosal dysplasia were characterized by coarse-grained thyroid parenchyma, which was more common by 2.2 times as compared to the group of patients with atrophy (P > 0.05) and by 1.8 times as compared to the patients with intestinal metaplasia (χ2 = 4.09, P < 0.05).

Conclusions. Diagnostic criteria for the formation of a risk group for the detection of gastric mucosal dysplasia are focal changes in the thyroid parenchyma (sensitivity 63.6 %, specificity 71.4 %), coarse granularity of the thyroid parenchyma (sensitivity 72.7 %, specificity 61.4 %) and an increased vascularization of parenchyma at the sonological examination of the thyroid gland (sensitivity 63.6 %, specificity 70.0 %).

Author Biographies

Yu. M. Stepanov, SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”, Dnipro

MD, PhD, DSc, Professor, Corresponding Member of the NAMS of Ukraine, Director

L. M. Mosiichuk, SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”, Dnipro

MD, PhD, DSc, Senior Researcher, Head of the Department of Diseases of the Stomach and Duodenum, Dietetics and Medical Nutrition

I. S. Konenko, SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”, Dnipro

MD, PhD, Senior Researcher of the Department of Mini-invasive Endoscopic Interventions and Instrumental Diagnostics

O. V. Simonova, SI «Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine», Dnipro

MD, PhD, Senior Researcher of the Department of Mini-invasive Endoscopic Interventions and Instrumental Diagnostics

O. P. Petishko, SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”, Dnipro

Researcher of the Department of Scientific-Organizational, Methodical Work and Information Technologies

O. M. Shevtsova, SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”, Dnipro

Junior Researcher of the Department of Diseases of the Stomach and Duodenum, Dietetics and Medical Nutrition

L. V. Demeshkina, SI “Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine”, Dnipro

MD, PhD, Senior Researcher of the Department of Diseases of the Stomach and Duodenum, Dietetics and Medical Nutrition

References

Annibale, B., Esposito, G., & Lahner, E. (2020). A current clinical overview of atrophic gastritis. Expert Review of Gastroenterology & Hepatology, 14(2), 93-102. https://doi.org/10.1080/17474124.2020.1718491

Lahner, E., Zagari, R. M., Zullo, A., Di Sabatino, A., Meggio, A., Cesaro, P., Lenti, M. V., Annibale, B., & Corazza, G. R. (2019). Chronic atrophic gastritis: Natural history, diagnosis and therapeutic management. A position paper by the Italian Society of Hospital Gastroenterologists and Digestive Endoscopists [AIGO], the Italian Society of Digestive Endoscopy [SIED], the Italian Society of Gastroenterology [SIGE], and the Italian Society of Internal Medicine [SIMI]. Digestive and Liver Disease, 51(12), 1621-1632. https://doi.org/10.1016/j.dld.2019.09.016

Kim, Y. J., Lee, S. Y., Yang, H., Kim, J. H., Sung, I. K., & Park, H. S. (2019). Nodular Gastritis as a Precursor Lesion of Atrophic and Metaplastic Gastritis. Korean Journal of Gastroenterology, 73(6), 332-340. https://doi.org/10.4166/kjg.2019.73.6.332

Yoon, K., & Kim, N. (2018). Reversibility of Atrophic Gastritis and Intestinal Metaplasia by Eradication of Helicobacter pylori. Korean Journal of Gastroenterology, 72(3), 104-115. https://doi.org/10.4166/kjg.2018.72.3.104

Vannella, L., Lahner, E., & Annibale, B. (2012). Risk for gastric neoplasias in patients with chronic atrophic gastritis: a critical reappraisal. World Journal of Gastroenterology, 18(12), 1279-1285. https://doi.org/10.3748/wjg.v18.i12.1279

Pimentel-Nunes, P., Libânio, D., Marcos-Pinto, R., Areia, M., Leja, M., Esposito, G., Garrido, M., Kikuste, I., Megraud, F., Matysiak-Budnik, T., Annibale, B., Dumonceau, J. M., Barros, R., Fléjou, J. F., Carneiro, F., van Hooft, J. E., Kuipers, E. J., & Dinis-Ribeiro, M. (2019). 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 Endoscopia Digestiva (SPED) guideline update 2019. Endoscopy, 51(4), 365-388. https://doi.org/10.1055/a-0859-1883

Correa, P., & Piazuelo, M. B. (2012). The gastric precancerous cascade. Journal of Digestive Diseases, 13(1), 2-9. https://doi.org/10.1111/j.1751-2980.2011.00550.x

Sugano, K., Tack, J., Kuipers, E. J., Graham, D. Y., El-Omar, E. M., Miura, S., Haruma, K., Asaka, M., Uemura, N., Malfertheiner, P., & faculty members of Kyoto Global Consensus Conference. (2015). Kyoto global consensus report on Helicobacter pylori gastritis. Gut, 64(9), 1353-1367. https://doi.org/10.1136/gutjnl-2015-309252

Zhou, F., Wu, L., Huang, M., Jin, Q., Qin, Y., & Chen, J. (2018). The accuracy of magnifying narrow band imaging (ME-NBI) in distinguishing between cancerous and noncancerous gastric lesions: A meta-analysis. Medicine, 97(9), Article e9780. https://doi.org/10.1097/MD.0000000000009780

Boscolo Nata, F., Tirelli, G., Capriotti, V., Marcuzzo, A. V., Sacchet, E., Šuran-Brunelli, A. N., & de Manzini, N. (2021). NBI utility in oncologic surgery: An organ by organ review. Surgical Oncology, 36, 65-75. https://doi.org/10.1016/j.suronc.2020.11.017

Kamyshna, І. І., Pavlovich, L. B., Maslyanko, V. A., & Chornenka, Zh. A. (2021). Epidemiological assessment of dymamics of the prevalence and incidence of the thyroid gland diseases in Ukraine and chernivtsi region. Сlinical and experimental pathology, 20(3), 75-81. https://doi.org/10.24061/1727-4338.XX.3.77.2021.11

Skrypnyk, N. V., & Marusyn, O. V. (2017). Dynamika zakhvoriuvanosti y poshyrenosti vuzlovykh utvoren shchytopodibnoi zalozy za desiatyrichnyi period (2006-2016 rr.) v Ukraini ta na Prykarpatti [Dynamics of incidence and prevalence of thyroid gland nodules in Ukraine and in the Carpathian region for ten years (2006-2016)]. Praktykuiuchyi likar, 6(2), 26-29. [in Ukrainian].

Chukur, O. O. (2018). Dynamika zakhvoriuvanosti y poshyrenosti patolohii shchytopodibnoi zalozy sered dorosloho naselennia Ukrainy [Dynamics of morbidity and expansion of pathology of the thyroid gland among adult population of Ukraine]. Visnyk sotsialnoi hihiieny ta orhanizatsii okhorony zdorovia Ukrainy, (4), 19-25. https://doi.org/10.11603/1681-2786.2018.4.10020 [in Ukrainian].

Tkachenko, V. I., Maksymets, Ya. A., Vydyborets, N. V., & Kovalenko, O. F. (2018). Analiz poshyrenosti tyreoidnoi patolohii ta zakhvoriuvanosti na nei sered naselennia Kyivskoi oblasti ta Ukrainy za 2007-2017 rr. [Analysis of the prevalence and morbidity of thyroid pathology among the population of Kyiv region and Ukraine for 2007-2017]. Mìžnarodnij endokrinologìčnij žurnal, 14(3), 279-284. https://doi.org/10.22141/2224-0721.14.3.2018.136426 [in Ukrainian].

Venerito, M., Link, A., Rokkas, T., & Malfertheiner, P. (2016). Gastric cancer - clinical and epidemiological aspects. Helicobacter, 21(S1), 39-44. https://doi.org/10.1111/hel.12339

Dobruch-Sobczak, K., Jędrzejowski, M., Jakubowski, W., & Trzebińska, A. (2014). Errors and mistakes in ultrasound diagnostics of the thyroid gland. Journal of Ultrasonography, 14(56), 61-73. https://doi.org/10.15557/JoU.2014.0006

Gajda, S. N., Kuryłowicz, A., Żach, M., Bednarczuk, T., & Wyleżoł, M. (2019). Diagnosis and treatment of thyroid disorders in obese patients - what do we know? Endokrynologia Polska, 70(3), 271-276. https://doi.org/10.5603/EP.a2018.0089

Alexander, L. F., Patel, N. J., Caserta, M. P., & Robbin, M. L. (2020). Thyroid Ultrasound: Diffuse and Nodular Disease. Radiologic Clinics of North America, 58(6), 1041-1057. https://doi.org/10.1016/j.rcl.2020.07.003

Kandemir, E. G., Yonem, A., & Narin, Y. (2005). Gastric Carcinoma and Thyroid Status. Journal of International Medical Research, 33(2), 222-227. https://doi.org/10.1177/147323000503300210

Abnet, C. C., Fan, J. H., Kamangar, F., Sun, X. D., Taylor, P. R., Ren, J. S., Mark, S. D., Zhao, P., Fraumeni, J. F., Jr, Qiao, Y. L., & Dawsey, S. M. (2006). Self-reported goiter is associated with a significantly increased risk of gastric noncardia adenocarcinoma in a large population-based Chinese cohort. International Journal of Cancer, 119(6), 1508-1510. https://doi.org/10.1002/ijc.21993

Brown, A. R., Simmen, R. C., & Simmen, F. A. (2013). The Role of Thyroid Hormone Signaling in the Prevention of Digestive System Cancers. International Journal of Molecular Sciences, 14(8), 16240-16257. https://doi.org/10.3390/ijms140816240

Downloads

Published

2022-05-30

How to Cite

1.
Stepanov YM, Mosiichuk LM, Konenko IS, Simonova OV, Petishko OP, Shevtsova OM, Demeshkina LV. Ultrasound criteria for predicting pre-cancer changes of the gastric mucosa in patients with chronic atrophic gastritis combined with thyroid pathology. Zaporozhye medical journal [Internet]. 2022May30 [cited 2024Apr.20];24(3):286-92. Available from: http://zmj.zsmu.edu.ua/article/view/252716

Issue

Section

Original research