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Relationship between Endoscopic and Histologic Gastric Atrophy and Intestinal Metaplasia
Author(s) -
Quach Duc Trong,
Le Huy Minh,
Hiyama Toru,
Nguyen Oanh Thuy,
Nguyen Trung Sao,
Uemura Naomi
Publication year - 2013
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12027
Subject(s) - gastroenterology , medicine , intestinal metaplasia , stage (stratigraphy) , gastritis , atrophy , cancer , helicobacter pylori , biology , paleontology
Background The severity of endoscopic gastric atrophy ( EGA ), high‐stage O perative L ink on G astritis A ssessment ( OLGA ) gastritis (i.e., stage III or IV ), and extensive intestinal metaplasia ( IM ) with incomplete subtype have been separately reported as high‐risk factors of gastric cancer (GC). The aim of this study was to evaluate the associations between these endoscopic and pathologic characteristics. Materials and methods A cross‐sectional study was conducted on 280 patients with functional dyspepsia at the U niversity M edical C enter at H o C hi M inh C ity, V ietnam. Biopsies were taken according to the updated S ydney S ystem. EGA was assessed according to the K imura– T akemoto classification, and gastritis stage was assessed according to the OLGA system. Results All of patients with high‐stage OLGA gastritis (i.e., stage III or IV ) clustered in the subgroup of patients with moderate‐to‐severe EGA : 13/126 (10.3%) in patients with moderate‐to‐severe EGA versus 0/154 (0%) in patients with none‐to‐mild EGA ( p < .001). Moderate‐to‐severe EGA was also significantly associated with extensive IM ( p < .001, OR = 28.1 ( CI 95% 6.4–173.3)) and incomplete IM subtype ( p < .001, OR = 36.7 ( CI 95% 5.1–742.1). Extensive IM was also associated with incomplete IM subtype ( p = .01). Conclusions High‐stage OLGA gastritis, extensive IM with incomplete subtype clustered in patients with moderate‐to‐severe EGA . Assessing the severity of EGA could potentially help to identify patients who should be taken systemic biopsy for evaluating GC risk.