Gastric Cancer, Gastric Intestinal Metaplasia, Gastric Atrophy, Gastric Dysplasia
Conditions
Keywords
gastric precancerous lesions, gastric cancer, gastric intestinal Metaplasia, gastric atrophy, gastric dysplasia
Brief summary
The project will aim to identify and determine subgroups of patients with different risks of progression to gastric cancer and to assess appropriate follow-up intervals. Implementing risk stratification only high risk individuals will be offered and performed endoscopic surveillance.
Detailed description
Gastric cancer is still an important healthcare problem with significant mortality rates. Latvia is a high incidence country of gastric cancer. Unfortunately most of the gastric cancer cases in Latvia are diagnosed at late stages when the treatment is substantially less effective. Ideally, gastric cancer could be prevented by detecting gastric precancerous conditions/lesions and identifying those individuals at high-risk of progressing to cancer to the follow-up. Population based endoscopic screening for gastric cancer is not recommended for the early detection of gastric cancer generally deemed not to be cost-effective. However, in the absence of screening, patients present with advanced disease, and prognosis is poor. Targeted endoscopic surveillance strategies for gastric cancer should be introduced following the principles of the recent European guidelines: Management of precancerous conditions and lesions in the stomach (MAPS) (Dinis-Ribeiro, Areia et al. 2012). The project will aim to identify and determine subgroups of patients with different risks of progression to gastric cancer and to assess appropriate follow-up intervals. Implementing risk stratification only high risk individuals will be offered endoscopic surveillance.
Interventions
PROCEDUREUpper endoscopy with biopsies
Upper endoscopy with proper biopsy work-up will be used for identification and stratification of gastric lesions as well as acquisition of biopsies for histopathological examination, including H.pylori detection
PROCEDUREPlasma/serum sampling
Plasma/serum sampling will be used to obtain information for group stratification, e.g. H.pylori status determination, serum biomarkers
PROCEDUREBiopsies for gastric microbiota
During upper endoscopy biopsies for gastric microbiota analysis will be obtained
PROCEDUREFaecal sample acquisition
Faecal samples will be obtained for faecal occult blood testing as well as microbiota analysis
Sponsors
Digestive Diseases Centre GASTRO
Riga East Clinical University Hospital
Academic Histology Laboratory (Latvia)
University of Latvia
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Patients undergoing upper endoscopy Motivation to participate in the study Signed consent
Exclusion criteria
Known gastric cancer Unwillingness or inability to co-operate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Risk stratification | At baseline | The patients with material of standardized biopsies according to the standard criteria (updated Sydney system) will be classified in different risk groups for progressing to gastric cancer. The measurements for the risk stratification will be used following the updated Sydney grading and classification system e.g. degree and extent of atrophy, intestinal metaplasia and dysplasia in the stomach mucosa |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Scheduled follow-up procedures (gastroscopies) for high risk group patients | At baseline and then 1 and 3 years after the intervention depending on hystopathological report through study completion | The subgroup of patients at different risk of progression to gastric cancer will be selected and appropriate follow-up intervals will be scheduled and performed. Significant risk stage changes before and after the follow-up upper endoscopy in different research groups. |
| Gastric, faecal microbiome in cancer patients and patients with precancerous lesions | At baseline and then 1 and 3 years after the intervention depending on hystopathological report through study completion | Significant differences in the composition of gastric, faecal microbiome (phyla, genera) in cancer patients and patients with precancerous lesions |
Countries
Latvia
Contacts
Primary ContactIlze Kikuste, PhD
Outcome results
None listed