Since March last year, Old Li, who is in his 50s, has been experiencing epigastric pain, bloating, belching and acid reflux, and was diagnosed with chronic atrophic gastritis by gastroscopy. When he saw the gastroscopy report, he was worried because he heard that chronic atrophic gastritis would turn into gastric cancer sooner or later. Is this fear justified? The definition of chronic atrophic gastritis: Chronic atrophic gastritis is a common digestive disease characterized by atrophy of the intrinsic glands of the gastric mucosa, accounting for 10% to 20% of chronic gastritis. The disease is most commonly seen in middle-aged and elderly people, and the incidence increases with age. Gastroscopy and gastric mucosal biopsy are the most reliable diagnostic methods. Chronic atrophic gastritis refers to chronic gastritis in which atrophic changes in the gastric mucosa have occurred and can be divided into two categories: multifocal atrophic gastritis and autoimmune gastritis. The former atrophic changes are multifocal atrophy in the stomach, mainly in the gastric sinus, and mostly developed from chronic non-atrophic gastritis caused by Helicobacter pylori infection, while the latter atrophic changes are mainly in the gastric body, and mostly developed from autoimmune induced gastric body gastritis. Gastroscopically normal gastric mucosal surface is smooth, mucus-covered, and rich in folds generally appearing talk pink. In contrast, the endoscopy of patients with typical atrophic gastritis reveals that the gastric mucosa is lighter in color, the mucosa is thinner, the mucosal folds are reduced or absent, the submucosal vessels are permeable, and the surface is rough and uneven, granular or nodular. In fact, atrophic gastritis symptoms are not specific, and some patients do not even have obvious complaints. The common symptoms are mainly hidden pain and indigestion, such as: upper abdominal fullness, discomfort or pain, more pronounced after meals, belching, acid reflux, nausea, vomiting, loss of appetite and other indigestion symptoms. The diagnosis of chronic atrophic gastritis mainly relies on gastroscopy and cannot be judged by symptoms to determine whether the patient has atrophic gastritis. The patient’s symptoms are not proportional to what is seen on gastroscopy and the pathological findings. That is, patients without significant symptoms may have more severe atrophic gastritis; conversely, those with significant discomfort may not have atrophy of the gastric mucosa. The disease is complex, not a simple one-to-one correspondence, and requires comprehensive diagnosis and treatment. Chronic atrophic gastritis is not equal to cancer Chronic atrophic gastritis is a precancerous disease of gastric cancer, while chronic atrophic gastritis with intestinal epithelial hyperplasia or heterogeneous hyperplasia is a precancerous lesion, and the two concepts are different. Although atrophic lesions are common in the mucosa surrounding gastric cancer, there is no conclusion that chronic atrophic gastritis will inevitably develop into gastric cancer. Whether chronic atrophic gastritis will develop into precancerous or cancerous lesions in the future should be analyzed on a case-by-case basis according to the degree of atrophy of the lesions, and cannot be generalized. The current medical consensus is that although chronic atrophic gastritis can become cancerous, the cancer rate is very low (most studies have found that the cancer rate does not exceed 3%), so it cannot be said in general that chronic atrophic gastritis is the precursor and prologue of gastric cancer, and the two cannot be equated. In recent years, scholars at home and abroad have done a lot of research on the relationship between chronic atrophic gastritis, H. pylori and gastric cancer, and found that the incidence of atrophic gastritis is high among people in areas with a high incidence of gastric cancer, but it is also related to the high incidence of H. pylori, whether it is H. pylori or atrophic gastritis that leads to gastric cancer does not need to be strictly distinguished, the two often coexist and together lead to heterogeneous hyperplasia of the gastric mucosa, treatment of H. pylori The treatment of H. pylori itself is also an aspect of the treatment of atrophic gastritis. The chronic atrophic gastritis must be reviewed regularly. Although the cancer rate of chronic atrophic gastritis is very low, but not unrelated, gastric cancer is developed step by step from the intestinal epithelial hyperplasia and heterotypic hyperplasia of atrophic gastritis. In order to minimize the possibility of cancer, standardized treatment and review are needed, so active prevention and treatment is still necessary and desirable. Chronic atrophic gastritis with incomplete colonic intestinal epithelial hyperplasia should be taken seriously and followed regularly for prevention. In order to monitor the dynamic changes of the lesion, gastroscopy should be reviewed regularly. In general, chronic atrophic gastritis (without significant intestinal epithelial hyperplasia and atypical hyperplasia) should be reviewed once every 3 years; incomplete colonic intestinal epithelial hyperplasia with mild atypical hyperplasia once a year; with moderate atypical hyperplasia once every 3 months; with severe atypical hyperplasia should be considered as cancerous and local lesions can be considered for excision or surgical removal to eliminate future problems. Chronic atrophic gastritis treatment: 1, anti-Helicobacter pylori treatment: Helicobacter pylori in the gastric epithelium parasitic, secreted toxins damage gastric epithelial cells and a series of secondary effects, ultimately leading to the occurrence of atrophic gastritis, atrophic gastritis in our country a large part because of the aggravation of H. pylori infection or induced, so the treatment of atrophic gastritis should first be anti-H. pylori treatment, in addition to the eradication of H. pylori In addition, the eradication of H. pylori also has a positive effect on the prevention of gastric cancer. 2, general treatment: including quit smoking, avoid alcohol, avoid too salty, spicy, too hot, strong tea, coffee, eat more fresh vegetables and fruits. Prevention and treatment of H. pylori infection, standardized antibacterial treatment and review. Establish good hygienic habits, meal sharing system, disinfection of tableware, treating family members together, etc. 3, the standard treatment of chronic atrophic gastritis: some people feel that atrophic gastritis is more stubborn, difficult to cure, in fact, the efficacy of poor treatment also consider whether the treatment is standardized. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. The actual fact is that you will be able to get a lot more than just a few of these. The more you have to do, the better the treatment of chronic atrophic gastritis: the sooner you find out about atrophic gastritis, the better the results. If you do not adhere to the treatment or review, you have to wait until the appearance of intestinal epithelial hyperplasia and atypical hyperplasia to pay attention to is not self-deception.