Comorbid conditions in gastric malignancies and their management in patients of the Northwestern federal district

Objective. To investigate risk factors and etiopathogenetically related comorbid conditions preceding the onset of gastric cancer (GC) to identify markers for early detection and potential prevention of malignant transformation. Materials and Methods. The retrospective study included 6.007 patients. All participants underwent esophagogastroduodenoscopy with gastric mucosal biopsy, testing for Helicobacter pylori, and selective autoimmune gastritis serological markers. Atrophic, inflammatory, and neoplastic changes of the gastric mucosa were evaluated. In patients with histologically confirmed GC, risk factors and comorbid conditions were analyzed. Results. GC of various histological types were identified in 126 patients. In 38 cases, biopsy sampling was performed according to the OLGA protocol. 33 were diagnosed with atrophic gastritis, including H. pylori-associated, autoimmune, and undifferentiated inactive gastritis. Non-atrophic H. pylori-associated gastritis was observed in 4 patients, while one patient had no inflammation in gastric mucosa. Hypochromic anemia was diagnosed in 15 patients, including 10 cases documented in the medical history; serum iron deficiency was detected in 12 patients and vitamin B12 deficiency in 6. Autoimmune thyroiditis and nodular goiter were identified in 12 patients, three of whom had previously undergone surgery for thyroid adenocarcinoma. Family history, smoking status, and alcohol consumption did not differ from population-based reference levels. Conclusion. Patients with GC exhibit a spectrum of clinically relevant comorbidities, including autoimmune thyroiditis, other autoimmune disorders, thyroid neoplasms, and anemia of various etiologies. These findings support the expansion of surveillance programs to include not only endoscopy but also targeted testing for H. pylori infection and markers of autoimmune gastritis.