Premium
Long‐term outcome of group D patients with negative serum anti‐ Helicobacter pylori antibody and positive serum pepsinogen test in healthy Koreans
Author(s) -
Han Yoo Min,
Chung Su Jin,
Choi Ji Min,
Lee Changhyun,
Kim Joo Sung
Publication year - 2018
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 - 10.1111/1751-2980.12660
Subject(s) - medicine , gastroenterology , atrophic gastritis , helicobacter pylori , intestinal metaplasia , odds ratio , confidence interval , pepsin , gastritis , antrum , antibody , family history , group b , cancer , stomach , immunology , biochemistry , chemistry , enzyme
OBJECTIVE The aim of this study was to assess the clinical characteristics and long‐term outcomes of group D patients (negative H. pylori antibodies and positive pepsinogen level). METHODS Group D patients were divided into two groups, that is, the limited endoscopic atrophic gastritis (EAG) group with EAG confined to the antrum and angle (C1 and C2) and the advanced EAG group with gastric body‐involved EAG (C3 to O3). We compared the progression of precursor lesions and the occurrence of gastric neoplasms between the two groups. RESULTS Among 107 group D patients, the advanced EAG group ( n = 60) was elder and had a lower pepsinogen I level and a lower pepsinogen I to II ratio (PGI/II) than the limited EAG group ( n = 47). Among the 52 patients who underwent a follow‐up endoscopy, three gastric neoplasms were detected (one in the limited and two in the advanced EAG groups). During a median follow‐up of 44 months, 10 (43.5%) patients in the limited and 13 (52.0%) in the advanced EAG groups showed EAG progression or newly occurred intestinal metaplasia. A family history of GC (odds ratio [OR] 44.974, 95% confidence interval [CI] 1.360–1487.087), a lower PGI/II (OR 0.247, 95% CI 0.085–0.717) and a longer follow‐up duration (OR 1.832, 95% CI 1.200–2.796) increased the risk of progression. CONCLUSION A family history of GC and low baseline PGI/II were independently associated with an increased risk of progression of precursor lesions of GC.