Increased Risk of Progression to Gastric Adenocarcinoma in Patients with Non-dysplastic Gastric Intestinal Metaplasia Versus a Control Population
| Autor: | Nikola S Natov, Yazan Daaboul, Pu Fang Hung, Moises Guelrud, Mark J. Sterling, Abraham Cherukara, Rohit Dhingra |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Physiology Biopsy Population Adenocarcinoma Gastroenterology 03 medical and health sciences 0302 clinical medicine Risk Factors Stomach Neoplasms Internal medicine Metaplasia medicine Humans Risk factor education Retrospective Studies education.field_of_study business.industry Incidence Intestinal metaplasia Retrospective cohort study Middle Aged Hepatology medicine.disease digestive system diseases Massachusetts Dysplasia Case-Control Studies 030220 oncology & carcinogenesis Disease Progression Female 030211 gastroenterology & hepatology Neoplasm Grading medicine.symptom business Precancerous Conditions |
| Zdroj: | Digestive Diseases and Sciences. 65:3316-3323 |
| ISSN: | 1573-2568 0163-2116 |
| DOI: | 10.1007/s10620-019-06031-5 |
| Popis: | In previous studies, the 5-year progression rate of gastric intestinal metaplasia to gastric adenocarcinoma has varied substantially. We investigated the incidence rate of dysplasia and gastric adenocarcinoma and the rate of progression among a cohort of patients with non-dysplastic gastric intestinal metaplasia. This is a single-center, single-cohort retrospective study. Patients who had undergone an EGD with biopsies from 01/01/1993 to 12/31/2013 were included. The primary outcome of interest was the composite of low-grade dysplasia, high-grade dysplasia, or adenocarcinoma. Time to progression and risk factor subgroup analyses were performed. A total of 1628 subjects were screened, of whom 358 met the inclusion criteria. A total of 21 first-time events were recorded. The annual incidence rate of low-grade dysplasia was 2.1 (95% CI 1.3–3.5) cases per 1000 person-years, 0.5 (95% 0.2–1.3) per 1000 person-years for high-grade dysplasia, and 0.8 (95% CI 0.3–1.6) cases per 1000 person-years for gastric adenocarcinoma. The historical control group had an annual adenocarcinoma incidence rate of 0.07 per 1000 person-years. The event rate in Asians was also noted to be significantly higher between years 0–8 as compared with patients of non-Asian race, and extensive intestinal metaplasia was an independent risk factor (HR = 4.06 (95% CI 1.45–11.34), p = 0.007). Patients with non-dysplastic gastric intestinal metaplasia may progress to dysplasia and gastric adenocarcinoma. The incidence rate of gastric adenocarcinoma is higher than that of the historical control population (0.07 per 1000 person-years). The presence of extensive intestinal metaplasia was a risk factor for progression of disease. Triennial EGD may be warranted in patients with non-dysplastic gastric intestinal metaplasia. |
| Databáze: | OpenAIRE |
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