Table 1

Gastric precancerous Conditions and Lesions

Precancerous conditionsPrecancerous lesions
H. pylori-associated gastritis
Autoimmune gastritis
Gastric (chronic) ulcer
Gastric stumps
Syndromic neoplastic diseases:

  • Li-Fraumeni syndrome

  • Hereditary breast and ovarian cancer

  • Lynch Syndrome

  • MUTYH-associated adenomatous polyposis (MAP)

  • Juvenile polyposis syndrome

  • PTEN hamartoma tumour syndrome (PHTS)

Early precancerous lesions (H. pylori-associated gastritis, Autoimmune gastritis)
▸ Gastritis Stage O
▸ Gastritis Stage I
▸ Gastritis Stage II
▸ Gastritis Stage III
▸ Gastritis Stage IV
Advanced precancerous lesions (H. pylori, Autoimmune, Syndromic neoplasia)
▸ Intra-Epithelial Neoplasia Low-grade (IEN-LG)
▸ Intra-Epithelial Neoplasia High-grade (IEN-HG)

  • Precancerous Conditions: clinically-defined diseases associated to increased (gastric and non-gastric) cancer risk, in which precancerous lesions may occur.

  • Precancerous Lesions: organic modification of the native mucosal status (at both phenotypic and molecular levels).

  • Gastritis stages recapitulate the multistep inflammatory/atrophic involvement of the gastric mucosa (mainly due to Helicobacter infection): their precancerous meaning is expected to increase along with the severity of the mucosa atrophy, as expressed by the gastritis stage.

  • Advanced precancerous lesions are basically focal, and mainly restricted to patients harboring extensive atrophic lesions (high-risk stages; Stages III and IV).

  • MUTYH–gene (located on chromosome 1p35); PTEN-gene (located on chromosome 10q22–23).