The Role of the Pathoanatomical Diagnosis «Chronic Gastritis» in the System of Personified Cancer Prevention

Abstract

Aim.The aim of the review is to systematize the principles of interpretation of morphological and molecular-cellular signs underlying the biopsy diagnosis of chronic gastritis from the standpoint of personified prevention of gastric cancer.Background. The chronicle of cancer prevention is presented as an evolution of views on the possibility of clinical interpretation of structural changes in the gastric mucosa such as early (inflammation, metaplasia, atrophy) and pronounced (intraepithelial neoplasia/dysplasia) precancerous changes. The protocols of taking gastric bioptates and their violations, the principles of formulating the pathoanatomical conclusion (Updated Sydney system, OLGA system) and a personalized forecast of the risk of gastric cancer are discussed. Molecular classification of gastric cancer is considered from the standpoint of carcinogenesis cascade and WHO 2010 histological classification. New molecular and cellular targets for the preparation of bismuth tripotassium dicitrate and practical steps of its use in the prevention of gastric cancer in chronic inflammation of the mucosa of various etiologies are conceptually described.Conclusion.  Biopsy diagnosis of chronic gastritis combined with the evaluation of gene structure (genetic polymorphism) and epigenomic mechanisms (microRNA) allows the risk of gastric cancer to be ranked in a particular patient even with early precancerous changes in the gastric mucosa. The activity of gastritis (infiltration of the mucosa with neutrophilic leukocytes) of any etiology is the theoretical justification for the use of bismuth tripotassium dicitrate pharmacological preparation to protect the genome of stem cells of the gastric epithelium as a secondary prevention of gastric cancer.