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Risk factors of early proximal gastric carcinoma in Chinese diagnosed using WHO criteria
Author(s) -
Fang Cheng,
Huang Qin,
Lu Lin,
Shi Jiong,
Sun Qi,
Xu Gui Fang,
Gold Jason,
Mashimo Hiroshi,
Zou Xiao Ping
Publication year - 2015
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12240
Subject(s) - medicine , intestinal metaplasia , gastroenterology , esophagogastroduodenoscopy , family history , odds ratio , reflux , cancer , helicobacter pylori , carcinoma , body mass index , incidence (geometry) , disease , endoscopy , physics , optics
Objective The incidence of proximal gastric carcinoma ( PGC ) is rising worldwide for unknown reasons. Herein we compare the risk factors of early PGC with distal gastric carcinoma ( DGC ) in patients treated at a single tertiary hospital in C hina. Methods Risk factors of 379 consecutive surgically resected early gastric carcinoma ( EGC ) diagnosed according to the 2010 W orld H ealth O rganization criteria were studied by reviewing their medical records and esophagogastroduodenoscopy/biopsy findings and interviewing patients and family members for the patients' history of environmental toxin exposure ( ETE ), dietary habits, family (FCH) and personal cancer history (PCH) and survival. Differences between PGC ( n = 115), DGC ( n = 264) and age‐matched and gender‐matched controls ( n = 225) were compared. Results Proportion of early PGC in all EGC patients was increased significantly ( P < 0.05). The independent risk factors for both PGC and DGC identified by multivariate analysis were intake of preserved food and little fruit, and gastric mucosal intestinal metaplasia and atrophy (all P < 0.05). Advanced age (odds ratio [ OR ] 9.83, P < 0.01), PCH ( OR 5.09, P < 0.05), a high body mass index (>24 kg/m 2 ) ( OR 2.79, P < 0.01) and ETE ( OR 2.31, P < 0.05) were independent risk factors for PGC, but not male gender, tobacco or alcohol abuse, hiatus hernia, gastroesophageal reflux disease or columnar‐lined esophagus. In contrast, FCH ( OR 2.34, P < 0.01) and Helicobacter pylori infection ( OR 2.81, P < 0.001) were independent risk factors for DGC . Conclusion Independent risk factors for PGC in Chinese patients differ from those of DGC or esophageal adenocarcinoma, supporting the classification of PGC as a separate gastric carcinoma entity in the Chinese populations.