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First‐degree relatives of patients with early‐onset gastric carcinoma show even at young ages a high prevalence of advanced OLGA / OLGIM stages and dysplasia
Author(s) -
MarcosPinto R.,
Carneiro F.,
DinisRibeiro M.,
Wen X.,
Lopes C.,
Figueiredo C.,
Machado J. C.,
Ferreira R. M.,
Reis C. A.,
Ferreira J.,
Pedroto I.,
Areias J.
Publication year - 2012
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.1365-2036.2012.05111.x
Subject(s) - medicine , intestinal metaplasia , dysplasia , gastroenterology , atrophic gastritis , gastritis , cancer , stage (stratigraphy) , helicobacter pylori , first degree relatives , carcinoma , family history , paleontology , biology
Summary Background First‐degree relatives ( FDR s) of early‐onset gastric carcinoma ( EOGC ) patients are at increased risk of cancer development. OLGA / OLGIM (Operative Link on Gastritis/Intestinal Metaplasia Assessment) classifications have been proposed for the identification of individuals at high risk of gastric cancer development. Aim To estimate the prevalence and severity of premalignant conditions and lesions in FDR s of EOGC patients. Methods A case–control study was conducted encompassing 103 FDR s of EOGC patients (cases) and 101 age‐ and gender‐matched controls, all submitted to upper GI endoscopy and OLGA and OLGIM used for staging as well as modified versions with exclusion of the biopsies from incisura angularis in the analysis. Results Helicobacter pylori infection was present in 82% of cases ( P = 0.001). Atrophy was present in 70% of cases ( OLGA stages I– IV ). High‐risk stages ( III – IV ) were identified only in cases (19%) ( P < 0.001). Dysplasia was diagnosed only in cases ( n = 7, P = 0.007). The application of OLGIM , modified OLGA and modified OLGIM classifications led to downgrade of stages in comparison with the original OLGA classification (27%, 15% and 30% respectively). In all classification systems, dysplastic lesions clustered (86%) in high‐risk stages. Conclusions FDR s of EOGC patients have, even at young ages, a high prevalence of H . pylori infection, high‐risk OLGA and OLGIM stages and dysplasia. These patients should undergo accurate endoscopic observation with at least four biopsies in antrum and corpus to allow adequate staging and follow‐up of premalignant conditions and lesions scored in high‐risk stages, in accordance with international guidelines recently proposed.