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Long‐term follow‐up in atrophic body gastritis patients: atrophy and intestinal metaplasia are persistent lesions irrespective of Helicobacter pylori infection
Author(s) -
LAHNER E.,
BORDI C.,
CATTARUZZA M. S.,
IANI C.,
MILIONE M.,
DELLE FAVE G.,
ANNIBALE B.
Publication year - 2005
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2005.02582.x
Subject(s) - atrophic gastritis , intestinal metaplasia , medicine , gastroenterology , dysplasia , helicobacter pylori , atrophy , gastritis , metaplasia , antrum , histology , serology , pathology , stomach , immunology , antibody
Summary Background : Long‐term outcome of atrophic body gastritis has not yet been defined. Aim : To investigate at long‐term follow‐up the behaviour of atrophy and intestinal metaplasia and the occurrence of neoplastic lesions in atrophic body gastritis patients. Methods : Overall 106 atrophic body gastritis patients with ≥ 4‐year follow‐up were studied; 38 were Helicobacter pylori ‐positive at histology + serology and cured of infection (group A), 36 were positive at serology and not treated (group B) and 32 were H. pylori ‐negative (group C). Patients underwent gastroscopy with antral ( n = 3) and body ( n = 3) biopsies for histology according to the Sydney System. Results : At 6.7‐year follow‐up body atrophy and intestinal metaplasia remained unchanged in all 106 patients irrespective of H. pylori status. Antral atrophy was significantly increased at follow‐up only in group C, whereas antral intestinal metaplasia was unchanged in all three groups. During follow‐up eight (8%) patients developed neoplastic lesions (one adenocarcinoma, one adenoma with low‐grade dysplasia and six low‐grade dysplasia without endoscopic lesions). Antral atrophic gastritis was present at baseline in all but one (88%) of the eight patients with neoplastic lesions, but only in 15 (15%) of the 98 patients without ( P < 0.0001, RR = 26.7). Conclusions : Atrophy and intestinal metaplasia persist at 6.7‐year follow‐up and atrophic body gastritis patients with panatrophic gastritis are at increased risk of developing neoplastic lesions.