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Preventive effects of etodolac, a selective cyclooxygenase‐2 inhibitor, on cancer development in extensive metaplastic gastritis, a Helicobacter pylori ‐negative precancerous lesion
Author(s) -
Yanaoka Kimihiko,
Oka Masashi,
Yoshimura Noriko,
Deguchi Hisanobu,
Mukoubayashi Chizu,
Enomoto Shotaro,
Maekita Takao,
Inoue Izumi,
Ueda Kazuki,
Utsunomiya Hirotoshi,
Iguchi Mikitaka,
Tamai Hideyuki,
Fujishiro Mitsuhiro,
Nakamura Yasushi,
Tsukamoto Tetsuya,
Inada Kenichi,
Takeshita Tatsuya,
Ichinose Masao
Publication year - 2009
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.24862
Subject(s) - etodolac , helicobacter pylori , medicine , gastroenterology , atrophic gastritis , cancer , gastritis , incidence (geometry) , stomach cancer , stomach , physics , optics
The present study investigated the preventive effects of etodolac, a selective cyclo‐oxygenase (COX)‐2 inhibitor, on metachronous cancer development after endoscopic resection of early gastric cancer. Among 267 early gastric cancer patients who underwent endoscopic resection, 47 patients with extensive metaplastic gastritis were selected based on endoscopic findings and our previously described criteria of serum pepsinogen (PG) test‐positive and Helicobacter pylori antibody‐negative conditions. Nonrandomized etodolac treatment (300 mg/day) was administered to 26 patients (Group A), while the remaining 21 patients were untreated (Group B). No significant differences in age, sex distribution, lifestyle factors or extent of metaplastic gastritis at baseline were identified between groups. Patients were followed for metachronous cancer development with endoscopy every 6–12 months for up to 5 years. Mean (standard deviation) follow‐up period was 4.2 (0.9) years. In Group B, 5 cancers developed (incidence rate = 6,266/100,000 person‐years), significantly more than the 1 cancer in Group A (incidence rate = 898/100,000 person‐years; p < 0.05). Long‐term etodolac treatment did not influence the extent of metaplastic gastritis as revealed by endoscopic findings or by serum PG levels, but effectively reduced metachronous cancer development in patients with extensive metaplastic gastritis. These results strongly suggest that chemoprevention of cancer in the metaplastic stomach is possible by controlling COX‐2 expression.