BACKGROUND/OBJECTIVES: Gastric cancer (GC) incidence remains high worldwide, and the survival rate is poor. GC develops from atrophic gastritis (AG), associated with () infection, passing through intestinal metaplasia and dysplasia steps. Since eradication does not exclude GC development, further investigations are needed. New data suggest the possible role of unexplored gastric microbiota beyond in the progression from AG to GC. Aimed to develop a score that could be used in clinical practice to stratify GC progression risk, here was investigate gastric microbiota in AG -negative patients with or without high-grade dysplasia (HGD) or GC.

METHODS

Consecutive patients undergoing upper endoscopy within an endoscopic follow-up for AG were considered. The antrum and corpus biopsies were used to assess the microbiota composition along the disease progression by sequencing the 16S ribosomal RNA gene. Statistical differences between HGD/GC and AG patients were included in a multivariate analysis.

RESULTS

HGD/GC patients had a higher percentage of in the antrum and a low abundance of Rhizobiales, Weeksellaceae and in the corpus. These data were used to calculate a multiparametric score (Resident Gastric Microbiota Dysbiosis Test, RGM-DT) to predict the risk of progression toward HGD/GC. The performance of RGM-DT in discriminating patients with HGD/GC showed a specificity of 88.9%.

CONCLUSIONS

The microbiome-based risk prediction model for GC could clarify the role of gastric microbiota as a cancer risk biomarker to be used in clinical practice. The proposed test might be used to personalize follow-up program thanks to a better cancer risk stratification.