Decline of gastric cancer mortality in common variable immunodeficiency in the years 2018-2022

Frontiers in Immunology

Immunology

Giulia Costanzo¹  Davide Firinu¹  Cinzia Milito²  Giulia Garzi²  Isabella Quinti²  Eleonora Sculco²  Gianluca Lagnese³  Giuseppe Spadaro³  Alessandra Punziano³  Simona Ferrari⁴  Claudia Discardi⁵  Carla Felice⁵  Francesco Cinetto⁵  Federica Pulvirenti⁶ 

[1] Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy;Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy;Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy;Medical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy;Rare Diseases Referral Center, Internal Medicine 1, Ca’ Foncello Hospital, AULSS2 Marca Trevigiana, Department of Medicine (DIMED), University of Padova, Padova, Italy;Reference Center for Primary Immune Deficiencies, AOU Policlinico Umberto I, Rome, Italy;

关键词: gastric cancer;    common variable immunodeficiency;    mortality;    endoscopy;    screening;    Helicobacter pylori;    gastric adenocarcinoma;    COVID-19;   

DOI  :  10.3389/fimmu.2023.1231242

 received in 2023-05-30, accepted in 2023-09-18,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionIn patients with Common Variable Immunodeficiency, malignancy has been reported as the leading cause of death in adults, with a high risk of B-cell lymphomas and gastric cancer.MethodsWe conducted a five-year prospective study aiming to update the incidence and mortality of gastric cancer and the incidence of gastric precancerous lesions in 512 CVID patients who underwent a total of 400 upper gastrointestinal endoscopies.ResultsIn the pre-pandemic period, 0.58 endoscopies were performed per patient/year and in the COVID-19 period, 0.39 endoscopies were performed per patient/year. Histology revealed areas with precancerous lesions in about a third of patients. Patients who had more than one gastroscopy during the study period were more likely to have precancerous lesions. Two patients received a diagnosis of gastric cancer in the absence of Helicobacter pylori infection. The overall prevalence of Helicobacter pylori infection in biopsy specimens was 19.8% and related only to active gastritis. Among patients who had repeated gastroscopies, about 20% progressed to precancerous lesions, mostly independent of Helicobacter pylori.DiscussionWhile gastric cancer accounted for one in five deaths from CVID in our previous survey, no gastric cancer deaths were recorded in the past five years, likely consistent with the decline in stomach cancer mortality observed in the general population. However, during the COVID-19 pandemic, cancer screening has been delayed. Whether such a delay or true decline could be the reason for the lack of gastric cancer detection seen in CVID may become clear in the coming years. Due to the high incidence of precancerous lesions, we cannot rely on observed and predicted trends in gastric cancer mortality and strongly recommend tailored surveillance programs.

【 授权许可】

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Copyright © 2023 Milito, Pulvirenti, Garzi, Sculco, Cinetto, Firinu, Lagnese, Punziano, Discardi, Costanzo, Felice, Spadaro, Ferrari and Quinti