Risk of Progression of Gastric Intestinal Metaplasia Is Significantly Greater When Detected in Both Antrum and Body
Autor: | Stephen Crowther, Adam Bowden, Colm O'Morain, Paul F. Ridgway, Eoin Farrell, Joshua Weininger, Deirdre McNamara, Anthony O'Connor |
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Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty Physiology education Gastroenterology Gastric Intestinal Metaplasia 03 medical and health sciences 0302 clinical medicine Stomach Neoplasms Internal medicine medicine Humans Esophagus Antrum Metaplasia business.industry Stomach Cancer Intestinal metaplasia Middle Aged Hepatology medicine.disease medicine.anatomical_structure Increased risk Dysplasia 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology business Precancerous Conditions |
Zdroj: | Digestive Diseases and Sciences. 66:3470-3475 |
ISSN: | 1573-2568 0163-2116 |
Popis: | Gastric cancer (GC) is the fifth leading cause of cancer-related death worldwide. GC is usually preceded by a cascade of well-defined precursor lesions, set in place by an environmental trigger (H. pylori) including intestinal metaplasia (GIM) and dysplasia. To investigate the rates of progression of GIM to dysplasia and GC in a region of low gastric cancer incidence. We identified all patients diagnosed with GIM between January 1, 2008, and June 30, 2012. Any repeat upper endoscopy more than 1 year after index diagnosis and before December 31, 2018, was considered follow-up. Carcinomas the bulk of which were macroscopically located below the OGJ were considered primary gastric cancer. Progression to more advanced lesions was observed in six patients (0.6%). Four patients (three male) developed GC at median age 74 years (SD 6). Two patients progressed to dysplasia (one male) at median age 71 years (SD 4). Patients with GIM in both gastric antrum and body were significantly more likely to progress than those with GIM in only one location (3.1% vs. 0.4%) (p value 0.017). Fifty-eight patients who had H. pylori eradicated were followed up. No progression to dysplasia or GC was noted in this group, with 28 patients having persistent GIM at follow-up. Patients with GIM in both antrum and body had a significantly increased risk of progression and warrant close attention. This is comparable to routinely followed premalignant conditions such as Barrett’s esophagus and Colonic Polyps, and appropriate surveillance protocols should be followed in this group. |
Databáze: | OpenAIRE |
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