RISK FACTORS FOR PROGRESSION TO GASTRIC NEOPLASTIC LESIONS IN PATIENTS WITH ATROPHIC GASTRITIS.
Résumé
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.
Fichier principal
PEER_stage2_10.1111%2Fj.1365-2036.2010.04268.x.pdf (273.51 Ko)
Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)