Indicators of immune status in the blood of patients depending on the stage of atrophic gastritis according to the OLGA system

Background. Development of a gradation of precancerous lesions is aimed at improving the secondary prevention of neoplasms. This is facilitated by the search for factors that allow stratifying the severity of manifestations of atrophic gastritis (AG). Objective. The evaluation of indicators of the immune status in the blood of patients depending on the stage of AG according to the OLGA system. Methods. The study included 125 patients aged 18 to 80 years: 52 healthy volunteers (26 men and 26 women, mean age 48.2±4.0 years) undergoing annual medical examinations at the Research Institute of Medical Problems of the North, Federal Research Center “Krasnoyarsk Scientific Center of the Siberian Branch of the Russian Academy of Sciences", and 73 patients with AG (38 men and 35 women, mean age - 49.9±4.6 years). Healthy patients were determined on the basis of the absence of a gastroenterological medical history and clinical symptoms of digestive diseases, the blood pepsinogen-1 (PG-1) level >50 pg/L, and the PG-1/PG-2 ratio >3. All patients were H. pylori-positive. The diagnosis of AG was established by a gastroenterologist on the basis of a clinical examination, the presence of H. pylori infection and detection of atrophy of the gastric mucosa during histological examination. All patients underwent a standard clinical examination by a gastroenterologist and laboratory and instrumental studies. Fiberoptic esophagogastroduodenos-copy with a sampling of 5 biopsy specimens from the gastric mucosa was performed in 73 AG patients. Evaluation of AG was carried out according to the OLGA system in histological preparations stained with hematoxylin-eosin. H. pylori was determined by histological method in preparations stained by Romanowsky-Giemsa method. The study of the immune status included determining the number of leukocytes and lymphocytes and indicators of cellular immunity by indirect immunofluorescence of lymphocytes using monoclonal antibodies to CD3, CD4, CD8, CD16, CD19 (Sorbent LLP, Moscow). Results. Compared to healthy individuals, patients with stage III - IV chronic atrophic gastritis according to the OLGA system had inhibition of the T-cell immunity, manifested by a decrease in the absolute number of leukocytes and lymphocytes; a decrease in the absolute and relative levels of mature T-lymphocytes, CD4+ cells, immunoregulatory index (CD4+/CD8+) and NK cells. Impaired cellular immunity was associated with an increase in the stage of atrophy according to the OLGA system. Conclusion. The combination of the use of the OLGA morphological system with the determination of immune parameters increases the possibility of stratification of AG to determine the risk of developing gastric cancer.

OLGA, atrophic gastritis, OLGA, cellular immunity, T-lymphocytes, carcinogenesis