Risk Factors for Gastric Tumorigenesis in Underlying Gastric Mucosal Atrophy.
- Author:
Ji Hyun SONG
1
;
Sang Gyun KIM
;
Eun Hyo JIN
;
Joo Hyun LIM
;
Sun Young YANG
Author Information
- Publication Type:Original Article
- Keywords: Atrophy; Stomach; Neoplasms; Epidemiology
- MeSH: Adenoma; Alcohol Drinking; Atrophy*; Breath Tests; Carcinogenesis*; Classification; Cohort Studies; Endoscopy; Endoscopy, Gastrointestinal; Epidemiology; Follow-Up Studies; Gastritis, Atrophic; Helicobacter pylori; Humans; Immunoglobulin G; Metaplasia; Retrospective Studies; Risk Factors*; Stomach; Stomach Neoplasms; Urea; Urease
- From:Gut and Liver 2017;11(5):612-619
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Atrophic gastritis is considered a premalignant lesion. We aimed to evaluate the risk factors for gastric tumorigenesis in underlying mucosal atrophy. METHODS: A total of 10,185 subjects who underwent upper gastrointestinal endoscopy between 2003 and 2004 were enrolled in this retrospective cohort study. Follow-up endoscopy was performed between 2005 and 2014. Atrophic gastritis and intestinal metaplasia were assessed by endoscopy using the Kimura-Takemoto classification. Helicobacter pylori infection was evaluated based on serum immunoglobulin G antibody levels, the rapid urease test, or the urea breath test. RESULTS: Atrophic gastritis was confirmed in 3,714 patients at baseline; 2,144 patients were followed up for 6.9 years, and 1,138 exhibited increased atrophy. A total of 69 subjects were diagnosed with gastric neoplasm during follow-up (35 adenoma and 34 carcinoma). Age ≥55 years (hazard ratio [HR], 1.234), alcohol consumption (HR, 1.001), and H. pylori infection (HR, 1.580) were associated with increased mucosal atrophy. The risk factors for gastric neoplasm in underlying mucosal atrophy were age ≥55 years (HR, 2.582), alcohol consumption (HR, 1.003), extent of mucosal atrophy (HR, 2.285 in C3-O1; HR, 4.187 in O2–O3), and intestinal metaplasia (HR, 2.655). CONCLUSIONS: Extent of atrophy, intestinal metaplasia, and alcohol consumption are significant risk factors for gastric neoplasm in underlying mucosal atrophy.
