lvrachЛечащий ВрачLechaschi Vrach1560-51752687-1181ООО «Издательство "Открытые системы"»lvrach-305Research ArticleСтатьиСовременная стратегия ведения пациента с предраковыми заболеваниями желудкаModern strategy on managing patients with stomach pre-cancerЛазебникЛ. Б.LazebnikL. B.noemail@neicon.ruЛялюковаЕ. А.LyalukovaE. A.lyalykova@rambler.ruБеловаГ. В.BelovaG. V.noemail@neicon.ruДолгалёвИ. В.DolgalevI. V.noemail@neicon.ruКорочанскаяН. В.KorochanskayaN. V.noemail@neicon.ruКосёнокВ. К.KosenokV. K.noemail@neicon.ruЛялюковаА. С.LyalukovaA. S.noemail@neicon.ruОнучинаЕ. В.OnuchinaE. V.noemail@neicon.ruПетроваМ. М.PetrovaM. M.noemail@neicon.ruПрохороваЛ. В.ProkhorovaL. V.noemail@neicon.ruСарсенбаеваА. С.SarsenbaevaA. S.noemail@neicon.ruФГБОУ ВО МГМСУ им. А. И. Евдокимова МЗ РФRussian FederationФГБОУ ВО ОмГМУ МЗ РФRussian FederationМЦ ЦБ РФRussian FederationФГБОУ ВО СибГМУ МЗ РФRussian FederationФГБОУ ВО КубГМУ Минздрава РоссииRussian FederationГБУЗ ГБ № 3 г. Сочи Минздрава ККRussian FederationИГМАПО - филиал ФГБОУ ДПО РМАНПО МЗ РФRussian FederationФГБОУ ВО КрасГМУ им. проф. В. Ф. Войно-Ясенецкого МЗ РФRussian FederationФГБОУ ВО УрГМУ МЗ РФRussian FederationФГБОУ ВО Южно-Уральский ГМУ Минздрава РоссииRussian Federation201923062021096060Copyright © Лазебник Л.Б., Лялюкова Е.А., Белова Г.В., Долгалёв И.В., Корочанская Н.В., Косёнок В.К., Лялюкова А.С., Онучина Е.В., Петрова М.М., Прохорова Л.В., Сарсенбаева А.С., 20212021Лазебник Л.Б., Лялюкова Е.А., Белова Г.В., Долгалёв И.В., Корочанская Н.В., Косёнок В.К., Лялюкова А.С., Онучина Е.В., Петрова М.М., Прохорова Л.В., Сарсенбаева А.С.Lazebnik L.B., Lyalukova E.A., Belova G.V., Dolgalev I.V., Korochanskaya N.V., Kosenok V.K., Lyalukova A.S., Onuchina E.V., Petrova M.M., Prokhorova L.V., Sarsenbaeva A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.lvrach.ru/jour/article/view/305

Представлен обзор, обобщающий существующие международные рекомендации по ведению пациентов с атрофическим гастритом, кишечной метаплазией и дисплазией желудка. Показано, что пациенты с хроническим атрофическим гастритом или кишечной метаплазией имеют повышенный риск развития аденокарциномы желудка. Эрадикация Helicobacter pylori способствует купированию проявлений хронического неатрофического гастрита и может привести к частичной регрессии атрофического гастрита и снижает риск развития рака желудка.

The review summarize existing international recommendations for managing patients with atrophic gastritis, intestinal metaplasia and gastric dysplasia. It is shown that patients with chronic anthropic gastritis or intestinal metaplasia have an increased risk of stomach adenocarcinoma development. Helicobacter pylori eradication tends to relieve indications of chronic nonatrophic gastritis and can lead to partial regression of atrophic gastritis, and reduces the risk of stomach cancer development. 

Актуальная темаДисплазия желудкаПрофилактикаРак желудкаТерапияgastric dysplasiastomach cancerpreventionReferencesBray F., Ferlay J., Soerjomataram I. et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries // CA Cancer J Clin. 2018; 68: 393-424.Bray F., Ferlay J., Soerjomataram I. et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries // CA Cancer J Clin. 2018; 68: 393-424.Areia M., Spaander M. C., Kuipers E. J. et al. Endoscopic screening for gastric cancer: A cost-utility analysis for countries with an intermediate gastric cancer risk // United European Gastroenterol J. 2018; 6: 192-202.Areia M., Spaander M. C., Kuipers E. J. et al. Endoscopic screening for gastric cancer: A cost-utility analysis for countries with an intermediate gastric cancer risk // United European Gastroenterol J. 2018; 6: 192-202.Состояние онкологической помощи населению России в 2018 году / Под ред. А. Д. Каприна, В. В. Старинского, Г. В. Петровой. М.: МНИОИ им. П. А. Герцена - филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2019. 236 с.Состояние онкологической помощи населению России в 2018 году / Под ред. А. Д. Каприна, В. В. Старинского, Г. В. Петровой. М.: МНИОИ им. П. А. Герцена - филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2019. 236 с.Pimentel-Nunes P., Libanio 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., Flejou J.-F., Carneiro F., van Hooft J. E., Kuipers E. J., Dinis-Ribeiro M., Pedro P.-N. et al. 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. 2019; 51.Pimentel-Nunes P., Libanio 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., Flejou J.-F., Carneiro F., van Hooft J. E., Kuipers E. J., Dinis-Ribeiro M., Pedro P.-N. et al. 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. 2019; 51.Клинические рекомендации. Рак желудка. Министерство здравоохранения РФ, 2018 г.Клинические рекомендации. Рак желудка. Министерство здравоохранения РФ, 2018 г.Van der Post R. S., Vogelaar I. P., Carneiro F. et al. Hereditary diffuse gastric cancer: updated clinical guidelines with an emphasis on germline CDH1 mutation carriers // J Med Genet. 2015; 52: 361-374.Van der Post R. S., Vogelaar I. P., Carneiro F. et al. Hereditary diffuse gastric cancer: updated clinical guidelines with an emphasis on germline CDH1 mutation carriers // J Med Genet. 2015; 52: 361-374.Correa P. Human gastric carcinogenesis: a multistep and multifactorial process - First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention // Cancer Res. 1992; 52: 6735-6740.Correa P. Human gastric carcinogenesis: a multistep and multifactorial process - First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention // Cancer Res. 1992; 52: 6735-6740.Kapadia C. R. Gastric atrophy, metaplasia and dysplasia: a clinical perspective // J Clin Gastroenterol. 2003; 36: S29-36.Kapadia C. R. Gastric atrophy, metaplasia and dysplasia: a clinical perspective // J Clin Gastroenterol. 2003; 36: S29-36.Carneiro F., Machado J. C., David L. et al. Current thoughts on the histo- pathogenesis of gastric cancer // Eur J Cancer Prev. 2001; 10: 101-102.Carneiro F., Machado J. C., David L. et al. Current thoughts on the histo- pathogenesis of gastric cancer // Eur J Cancer Prev. 2001; 10: 101-102.Ihamaki T., Sankkonen M., Siurala M. Long-term observation of subjects with normal mucosa and with superficial gastritis: results of 23-27 years’ follow-up examinations // Scand J Gastroenterol. 1978; 13: 771-775.Ihamaki T., Sankkonen M., Siurala M. Long-term observation of subjects with normal mucosa and with superficial gastritis: results of 23-27 years’ follow-up examinations // Scand J Gastroenterol. 1978; 13: 771-775.Ormiston M. C., Gear M. W., Codling B. W. Five year follow-up study of gastritis // J Clin Pathol. 1982; 35: 757-760.Ormiston M. C., Gear M. W., Codling B. W. Five year follow-up study of gastritis // J Clin Pathol. 1982; 35: 757-760.Yue H., Shan L., Bin L. The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: a systematic review and meta-analysis // Gastric Cancer. 2018; 21: 579-587. Epub 19 февраля 2018 г.Yue H., Shan L., Bin L. The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: a systematic review and meta-analysis // Gastric Cancer. 2018; 21: 579-587. Epub 19 февраля 2018 г.Correa P. Clinical implications of recent developments in gastric cancer pathology and epidemiology // Semin Oncol. 1985; 12: 2-1025.Correa P. Clinical implications of recent developments in gastric cancer pathology and epidemiology // Semin Oncol. 1985; 12: 2-1025.Lauwers G., Carneiro F., Graham D. et al. Gastric carcinoma. In: Theise N., ed. WHO Classification of tumours of the digestive system. Lyon: IARC Press; 2010: 48-58.Lauwers G., Carneiro F., Graham D. et al. Gastric carcinoma. In: Theise N., ed. WHO Classification of tumours of the digestive system. Lyon: IARC Press; 2010: 48-58.Goo J. J., Choi C. W., Kang D. H. et al. Risk factors associated with diagnostic discrepancy of gastric indefinite neoplasia: Who need en bloc resection? // Surg Endosc. 2015; 29: 3761-3767.Goo J. J., Choi C. W., Kang D. H. et al. Risk factors associated with diagnostic discrepancy of gastric indefinite neoplasia: Who need en bloc resection? // Surg Endosc. 2015; 29: 3761-3767.Zhao G., Xue M., Hu Y. et al. How commonly is the diagnosis of gastric low grade dysplasia upgraded following endoscopic resection? A meta-analysis // PLoS One. 2015; 10: e0132699.Zhao G., Xue M., Hu Y. et al. How commonly is the diagnosis of gastric low grade dysplasia upgraded following endoscopic resection? A meta-analysis // PLoS One. 2015; 10: e0132699.Oliveira C., Pinheiro H., Figueiredo J. et al. Familial gastric cancer: genetic susceptibility, pathology, and implications for management // Lancet Oncol. 2015; 16: e60-e70.Oliveira C., Pinheiro H., Figueiredo J. et al. Familial gastric cancer: genetic susceptibility, pathology, and implications for management // Lancet Oncol. 2015; 16: e60-e70.Yaghoobi M., Bijarchi R., Narod S. A. Family history and the risk of gastric cancer // Br J Cancer. 2010; 102: 237-242.Yaghoobi M., Bijarchi R., Narod S. A. Family history and the risk of gastric cancer // Br J Cancer. 2010; 102: 237-242.Safaee A., Moghimi-Dehkordi B., Fatemi S. R. et al. Family history of cancer and risk of gastric cancer in Iran // Asian Pac J Cancer Prev. 2011; 12: 3117-3120.Safaee A., Moghimi-Dehkordi B., Fatemi S. R. et al. Family history of cancer and risk of gastric cancer in Iran // Asian Pac J Cancer Prev. 2011; 12: 3117-3120.Rokkas T., Sechopoulos P., Pistiolas D. et al. Helicobacter pylori infection and gastric histology in first-degree relatives of gastric cancer patients: a meta-analysis // Eur J Gastroenterol Hepatol. 2010; 22: 1128-1133.Rokkas T., Sechopoulos P., Pistiolas D. et al. Helicobacter pylori infection and gastric histology in first-degree relatives of gastric cancer patients: a meta-analysis // Eur J Gastroenterol Hepatol. 2010; 22: 1128-1133.Marcos-Pinto R., Carneiro F., Dinis-Ribeiro M. et al. First-degree relatives of patients with early-onset gastric carcinoma show even at young ages a high prevalence of advanced OLGA/OLGIM stages and dysplasia // Aliment Pharmacol Ther. 2012; 35: 1451-1459.Marcos-Pinto R., Carneiro F., Dinis-Ribeiro M. et al. First-degree relatives of patients with early-onset gastric carcinoma show even at young ages a high prevalence of advanced OLGA/OLGIM stages and dysplasia // Aliment Pharmacol Ther. 2012; 35: 1451-1459.Reddy K. M., Chang J. I., Shi J. M. et al. Risk of gastric cancer among patients with intestinal metaplasia of the stomach in a US integrated health care system // Clin Gastroenterol Hepatol. 2016; 14: 1420-1425.Reddy K. M., Chang J. I., Shi J. M. et al. Risk of gastric cancer among patients with intestinal metaplasia of the stomach in a US integrated health care system // Clin Gastroenterol Hepatol. 2016; 14: 1420-1425.Lahner E., Esposito G., Pilozzi E. et al. Occurrence of gastric cancer and carcinoids in atrophic gastritis during prospective long-term follow up // Scand J Gastroenterol. 2015; 50: 856-865.Lahner E., Esposito G., Pilozzi E. et al. Occurrence of gastric cancer and carcinoids in atrophic gastritis during prospective long-term follow up // Scand J Gastroenterol. 2015; 50: 856-865.Huang Y. K., Yu J. C., Kang W. M. et al. Significance of serum pepsinogens as a biomarker for gastric cancer and atrophic gastritis screening: a systematic review and meta-analysis // PLoS One. 2015; 10: e0142080.Huang Y. K., Yu J. C., Kang W. M. et al. Significance of serum pepsinogens as a biomarker for gastric cancer and atrophic gastritis screening: a systematic review and meta-analysis // PLoS One. 2015; 10: e0142080.Kitahara F., Kobayashi K., Sato T. et al. Accuracy of screening for gastric cancer using serum pepsinogen concentrations // Gut. 1999; 44: 693-697.Kitahara F., Kobayashi K., Sato T. et al. Accuracy of screening for gastric cancer using serum pepsinogen concentrations // Gut. 1999; 44: 693-697.Hsing A. W., Hansson L. E., McLaughlin J. K. et al. Pernicious anemia and subsequent cancer. A population-based cohort study // Cancer. 1993; 71: 745-750.Hsing A. W., Hansson L. E., McLaughlin J. K. et al. Pernicious anemia and subsequent cancer. A population-based cohort study // Cancer. 1993; 71: 745-750.Brinton L. A., Gridley G., Hrubec Z. et al. Cancer risk following pernicious anaemia // Br J Cancer. 1989; 59: 810-813.Brinton L. A., Gridley G., Hrubec Z. et al. Cancer risk following pernicious anaemia // Br J Cancer. 1989; 59: 810-813.Mera R. M., Bravo L. E., Camargo M. C. et al. Dynamics of Helicobacter pylori infection as a determinant of progression of gastric precancerous lesions: 16-year follow-up of an eradication trial // Gut. 2018; 67: 1239-1246. Epub 24 июня 2017 г.Mera R. M., Bravo L. E., Camargo M. C. et al. Dynamics of Helicobacter pylori infection as a determinant of progression of gastric precancerous lesions: 16-year follow-up of an eradication trial // Gut. 2018; 67: 1239-1246. Epub 24 июня 2017 г.Kamada T., Sato M., Tokutomi T. et al. Rebamipide improves chronic inflammation in the lesser curvature of the corpus after Helicobacter pylori eradication: a multicenter study // Biomed Res Int. 2015; 2015: 865146-865148.Kamada T., Sato M., Tokutomi T. et al. Rebamipide improves chronic inflammation in the lesser curvature of the corpus after Helicobacter pylori eradication: a multicenter study // Biomed Res Int. 2015; 2015: 865146-865148.Ивашкин В. Т., Маев И. В., Лапина Т. Л., Шептулин А. А., Трухманов А. С., Баранская Е. К., Абдулхаков Р. А., Алексеева О. П., Алексеенко С. А., Дехнич Н. Н., Козлов Р. С., Кляритская И. Л., Корочанская Н. В., Курилович С. А., Осипенко М. Ф., Симаненков В. И., Ткачев А. В., Хлынов И. Б., Цуканов В. В. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению инфекции Helicobacter pylori у взрослых // Рос. журн. гастроэнтерол. гепатол. колопроктол. 2018; 28 (1), с. 56-70.Ивашкин В. Т., Маев И. В., Лапина Т. Л., Шептулин А. А., Трухманов А. С., Баранская Е. К., Абдулхаков Р. А., Алексеева О. П., Алексеенко С. А., Дехнич Н. Н., Козлов Р. С., Кляритская И. Л., Корочанская Н. В., Курилович С. А., Осипенко М. Ф., Симаненков В. И., Ткачев А. В., Хлынов И. Б., Цуканов В. В. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению инфекции Helicobacter pylori у взрослых // Рос. журн. гастроэнтерол. гепатол. колопроктол. 2018; 28 (1), с. 56-70.Malfertheiner P. et al. Management of Helicobacter pylori infection Maastricht V/Florence Consensus Report // Gut. 2017, Jan; 66 (1): 6-30.Malfertheiner P. et al. Management of Helicobacter pylori infection Maastricht V/Florence Consensus Report // Gut. 2017, Jan; 66 (1): 6-30.Bertuccio P., Rosato V., Andreano A. et al. Dietary patterns and gastric cancer risk: a systematic review and meta-analysis // Ann Oncol. 2013; 24: 1450-1458Bertuccio P., Rosato V., Andreano A. et al. Dietary patterns and gastric cancer risk: a systematic review and meta-analysis // Ann Oncol. 2013; 24: 1450-1458Areia M., Dinis-Ribeiro M., Rocha Goncalves F. Cost-utility analysis of endoscopic surveillance of patients with gastric premalignant.conditions // Helicobacter. 2014; 19: 425-436.Areia M., Dinis-Ribeiro M., Rocha Goncalves F. Cost-utility analysis of endoscopic surveillance of patients with gastric premalignant.conditions // Helicobacter. 2014; 19: 425-436.Chang H. S., Park E. C., Chung W. et al. Comparing endoscopy and upper gastrointestinal X-ray for gastric cancer screening in South Korea: a cost-utility analysis // Asian Pac J Cancer Prev. 2012; 13: 2721-2728.Chang H. S., Park E. C., Chung W. et al. Comparing endoscopy and upper gastrointestinal X-ray for gastric cancer screening in South Korea: a cost-utility analysis // Asian Pac J Cancer Prev. 2012; 13: 2721-2728.Jun J. K., Choi K. S., Lee H. Y. et al. Effectiveness of the Korean national cancer screening program in reducing gastric cancer mortality // Gastroenterology. 2017; 152: 1319-1328.Jun J. K., Choi K. S., Lee H. Y. et al. Effectiveness of the Korean national cancer screening program in reducing gastric cancer mortality // Gastroenterology. 2017; 152: 1319-1328.

The authors declare that there are no conflicts of interest present.