Gut Liver.  2017 Sep;11(5):612-619. 10.5009/gnl16488.

Risk Factors for Gastric Tumorigenesis in Underlying Gastric Mucosal Atrophy

• Song JH
• Kim SG
• Jin EH
• Lim JH
• Yang SY

• KMID: 2389348
• DOI: http://doi.org/10.5009/gnl16488

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.

Keyword

Atrophy; Stomach; Neoplasms; Epidemiology

MeSH Terms

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
Immunoglobulin G
Urea
Urease