Histological intestinal metaplasia and endoscopic atrophy are predictors of gastric cancer development after Helicobacter pylori eradication - Gastrointestinal Endoscopy

Abstract Article Tools PDF (1 MB) Email Article Add to My Reading List Export Citation Create Citation Alert Cited by in Scopus (0) All Content Search Advanced Search | RegisterArticle Tools PDF (1 MB) Email Article Add to My Reading List Export Citation Create Citation Alert Cited by in Scopus (0) All Content Search Advanced Search | Register Articles in Press < Previous Article Next Article > Satoki Shichijo Yoshihiro Hirata Ryota Niikura Yoku Hayakawa Atsuo Yamada Tetsuo Ushiku Masashi Fukayama Kazuhiko Koike Access this article on ScienceDirect Articles & Issues Multimedia CME For Authors Journal Info Subscribe ASGE More Periodicals Histological intestinal metaplasia and endoscopic atrophy are predictors of gastric cancer development after Helicobacter pylori eradication Gastrointestinal Endoscopy http://www.giejournal.org/article/S0016-5107(16)01053-1/abstract[2016/04/16 22:13:49] Background and aim H pylori eradication therapy is effective at reducing gastric cancer incidence. However, gastric cancer still develops after eradication. We conducted a cohort study to elucidate the risk factors for gastric cancer development after successful H pylori eradication therapy. Methods From June 1998 to December 2012, we assessed histological and endoscopic findings of gastritis and performed H pylori eradication therapy in 748 patients without a history of gastric cancer. Patients were classified according to the distribution of intestinal metaplasia (IM) as follows: no IM (IM group A), IM in the antrum only (IM group B), and IM in the corpus (IM group C). We assessed atrophy endoscopically according to the Kimura-Takemoto classification system. Gastric cancer incidence was assessed. Results A total of 573 patients underwent follow-up endoscopy; the mean duration of follow-up was 6.2 ± 4.8 years. Gastric cancer developed in 21 (20 intestinal-type). The cumulative 5-year incidences of gastric cancer were 3.2% overall; 1.5%, 5.3%, and 9.8% in IM groups A, B, and C; and 0.7%, 1.9%, and 10% in the none/mild, moderate, and severe endoscopic atrophy groups, respectively. Compared with IM group A, the hazard ratio for IM group B was 3.6 (95% confidence interval [CI], 1.2-11), and that for IM group C was 3.7 (95% CI, 1.112). Compared with the none/mild endoscopic atrophy group, the hazard ratio for severe atrophy was 9.3 (95% CI, 1.7-174). Conclusion Patients with histological IM or severe endoscopic atrophy were at increased risk of gastric cancer development after H pylori eradication.