Risk Factors for Gastric Tumorigenesis in Underlying Gastric Mucosal Atrophy
Gut and Liver 2017³â 11±Ç 5È£ p.612 ~ p.619
¼ÛÁöÇö(Song Ji-Hyun) - Seoul National University Hospital Department of Internal Medicine
±è»ó±Õ(Kim Sang-Gyun) - Seoul National University College of Medicine Department of Internal Medicine
ÁøÀºÈ¿(Jin Eun-Hyo) - Seoul National University Hospital Department of Internal Medicine
ÀÓÁÖÇö(Lim Joo-Hyun) - Seoul National University Hospital Department of Internal Medicine
¾ç¼±¿µ(Yang Sun-Young) - Seoul National University Hospital Department of Internal Medicine
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 ¡Ã55 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 ¡Ã55 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.
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Atrophy, Stomach, Neoplasms, Epidemiology
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The risk factors for gastric neoplasm in underlying mucosal atrophy were age ¡Ã55 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).