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Risk factors for progression to gastric neoplastic lesions in patients with atrophic gastritis
Author(s) -
VANNELLA L.,
LAHNER E.,
OSBORN J.,
BORDI C.,
MIGLIONE M.,
DELLE FAVE G.,
ANNIBALE B.
Publication year - 2010
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.1365-2036.2010.04268.x
Subject(s) - atrophic gastritis , medicine , gastroenterology , intestinal metaplasia , gastritis , cancer , antrum , stomach
Aliment Pharmacol Ther 31 , 1042–1050 Summary Background Atrophic gastritis, involving the gastric body mucosa, predisposes to gastric neoplastic lesions (GNL). However, regular gastroscopic‐histological follow‐up for GNL is not recommended for patients with atrophic gastritis. Aim To evaluate risk factors for the progression to GNL in a cohort of patients with atrophic gastritis. Methods A total of 300 patients with atrophic gastritis [205 women, aged 54 (18–78) years] underwent gastroscopy with six gastric antrum and body biopsies. All patients had at least one follow‐up gastroscopy/histology at an interval of at least 1 year after the atrophic gastritis diagnosis. Baseline clinical and histological features were analysed as risk factors for the development of GNL by Cox‐regression. Results During a median follow‐up of 4.3 (1–16.5) years, 15 GNL were detected in 14 of the 300 patients with atrophic gastritis: three were gastric cancer, whereas 12 were non‐invasive neoplasia. The annual incidence for GNL was 1%. Cox‐regression analysis identified the following risk factors: age over 50 years (HR 8.8, 95%CI 1.2–68.4), atrophic pangastritis (HR 4.5, 95% CI 1.5–14.1) and severe intestinal metaplasia in the gastric body (HR 4.0, 95% CI 1.3–11.8). Conclusions Atrophic pangastritis, severe body intestinal metaplasia and/or age over 50 years increase the risk for developing GNL in patients with atrophic gastritis. In this subset of patients, an endoscopic‐histological follow‐up for GNL surveillance may be worthwhile.