RISK FACTORS FOR PROGRESSION TO GASTRIC NEOPLASTIC LESIONS IN PATIENTS WITH ATROPHIC GASTRITIS.

Lucy Vannella , Edith Lahner , John Osborn , Cesare Bordi (1) , Massimo Miglione , Gianfranco Delle Fave , Bruno None Annibale (2)

1 Pathology and Laboratory Medicine
2 Clinical Science

Background: Atrophic gastritis (AG), involving the gastric body mucosa, predisposes to gastric neoplastic lesions (GNL). In AG patients, regular gastroscopic-histological follow-up for GNL is not recommended. Aims:To evaluate in a cohort of AG patients risk factors for the progression to GNL. Methods: 300 AG patients (205 females, age 54[18-78]years) underwent gastroscopy with six gastric antrum and body biopsies. All patients had at least one follow-up gastroscopy/histology at an interval of at least one year after the AG diagnosis. Baseline clinical and histological features were analyzed as risk factors for the development of GNL by Cox-regression. Results: During a median follow-up of 4.3 (1-16.5)years, 15 GNL were detected in 14 of the 300 AG patients: 3 were gastric cancer, whereas 12 were non-invasive neoplasia. The annual incidence for GNL was 1%. Cox-regression analysis identified the following risk factors: age over 50 years (HR 8.8, 95%CI 1.2-68.4), atrophic pangastritis (HR 4.5, 95%CI 1.5-14.1) and severe intestinal metaplasia in the gastric body (HR 4.0, 95%CI 1.3-11.8). Conclusion: Atrophic pangastritis, severe body intestinal metaplasia and/or age over 50 years increase the risk for developing GNL in AG patients. In this subset of patients, an endoscopic-histological follow-up for GNL surveillance may be worthwhile.

Mots clés: Medicine

Lucy Vannella, Edith Lahner, John Osborn, Cesare Bordi, Massimo Miglione, et al.. RISK FACTORS FOR PROGRESSION TO GASTRIC NEOPLASTIC LESIONS IN PATIENTS WITH ATROPHIC GASTRITIS.. Alimentary Pharmacology and Therapeutics, 2010, ⟨10.1111/j.1365-2036.2010.04268.x⟩. ⟨hal-00552530⟩