Sa1672 A Family History of Gastric Cancer is Associated With the Presence of Gastric Intestinal Metaplasia in Patients Undergoing EGD With Biopsy (original) (raw)
Related papers
Predicting Gastric Intestinal Metaplasia in a High-Risk Population
Cureus
Introduction: Gastric intestinal metaplasia (GIM) is a precancerous lesion. It has a low prevalence rate in the United States. However, GIM is more common among non-White and immigrant populations. Harlem Hospital serves a community that includes predominantly African Americans, Hispanics, and immigrants from West Africa and Spanish-speaking Caribbean countries. This study aims to define the factors predicting GIM in this high-risk group as well as help define screening strategies for vulnerable populations. Methods: A total of 1351 patients who underwent endoscopic gastroduodenoscopy (EGD) and biopsy in 2018 and 2019 for any indication at Harlem Hospital were included in this study. Gastric biopsy specimens taken during the procedure were assessed for GIM by histopathology. Baseline demographics were collected, including age, sex, and ethnicity. Other information collected included risk factors for GIM such as Helicobacter pylori infection, smoking status, and the use of alcohol. Descriptive analysis was done and the Wilcoxon rank sum test and chi-squared test were used to test for associations. Multiple logistic regressions were used to assess the odds of independent factors associated with increased risk of GIM. Results: Of the 1351 patients reviewed, 106 had GIM for a prevalence of 8.0% (CI: 6.7%-9.6%, p < 0.001). Univariate analysis revealed older patients, males, history of smoking, alcohol, and H. pylori infection were significantly associated with GIM. Using multiple logistic regressions and adjusting for underlying risk factors, smoking (OR: 1.61, 95% CI: 1.00-2.570) and H. pylori infection (OR: 3.35, 95% CI: 2.18-5.15) continued to be significantly associated with increased risk of GIM; however, alcohol use was not significant after adjusting for other risk factors (OR: 1.10, 95% CI: 0.68-1.78). Hispanic risk for GIM was slightly higher than African Americans (OR: 1.17, 95% CI: 0.74-1.83). The predicted marginal effect of age on the odds of GIM was significant from age 40 and increased exponentially at age 50. By age 70, the odds of GIM were as high as 11% (95% CI: 8.3-13.6). Conclusion: The prevalence of GIM in our population is significantly higher compared to reported cases in the United States. Age, male gender, H. pylori infection, and smoking significantly increase the risk of GIM. Given the high prevalence of GIM in our population, early endoscopic screening would play an important role in evaluating dyspepsia to diagnose GIM with or without H. pylori infection. We propose screening all atrisk ethnicities from age 40 years with EGD according to the Sydney System biopsy protocol. We believe this will ultimately decrease the incidence of gastric cancer death in these vulnerable populations of color.
International Journal of Cancer, 2010
There are no established criteria to classify patients into high or low risk of progressing to gastric cancer (GC). The aim of the study was to identify predictors of GC occurrence among patients with gastric preneoplastic lesions. A prospective and retrospective follow-up study was carried out in a province in Spain with one of the highest risk of GC. The study included 478 patients who underwent gastric biopsy in 1988-1994 with diagnoses of normal mucosa, nonatrophic gastritis (NAG), non-metaplastic multifocal atrophic gastritis (MAG) and complete or incomplete intestinal metaplasia (IM) and who accepted to undergo a new biopsy during 2005-2007 or had an event during follow up. Inter-and intra-observer variability of histological diagnosis was assessed. Analysis was done using Cox proportional hazards risk (HR) models. The mean age of the patients was 50 years, 47% were males and the mean follow-up time was 12.8 years. During follow-up, 23 GC (4.8%) were diagnosed (21 adenocarcinomas and 2 lymphomas) with an incidence of 3.77 per 1,000 person per year. The incidence rate of GC for those with incomplete IM was 16.5 per 1,000 person years. Out the 21 adenocarcinomas, 16 had an incomplete IM in the baseline diagnosis. Incomplete IM (HR 11.3; 95% CI 3.8-33.9) and a family history of GC (HR 6.1; 95% CI 1.7-22.4) were the strongest risk factors for gastric adenocarcinoma. Subtyping of IM and family history of GC may be useful for the identification of high-risk patients who need more intensive surveillance.
Prevalence of High-Risk Groups for Gastric Carcinoma – A Biopsy Finding
Nepalese Medical Journal, 2018
Introduction: Gastric carcinoma is leading cause of death world wide including Nepal. The 5 years survival rate of gastric carcinoma (25%) has drastically decreased compared to early gastric cancers (90-90%) hence implying the need for early detection. Atrophic gastritis and intestinal metaplasia are considered as major high-risk factors and is a precancerous lesion along with Helicobacter pylori. This study tries to look at the distribution of atrophy and intestinal metaplasia across age and gender and their occurrence in Helicobacter pylori positive cases.Materials and methods: It is Cross-sectional study of a retrospectively collected data at KIST medical college and GRP poly clinic private limited from April 2008 till March 2018. Total of 10,683 cases were included. The slides were stained with Hematoxilin and Eosin stain and Giemsa stain and evaluated by two pathologists. Statistical analysis was done using SPSS vs 21.Results: Total numbers of cases studied were 10,683 with ma...
World Journal of Gastroenterology, 2006
AIM: To investigate the prevalence of H pylori associated corpus-predominant gastritis (CPG) or pangastritis, severe atrophy, and intestinal metaplasia (IM) in patients without any significant abnormal findings during upper-GI endoscopy. METHODS: Gastric biopsies from 3548 patients were obtained during upper GI-endoscopy in a 4-year period. Two biopsies from antrum and corpus were histologically assessed according to the updated Sydney-System. Eight hundred and forty-five patients (mean age 54.8 ± 2.8 years) with H pylori infection and no peptic ulcer or abnormal gross findings in the stomach were identified and analyzed according to gastritis phenotypes using different scoring systems. RESULTS: The prevalence of severe H pylori associated changes like pangastritis, CPG, IM, and severe atrophy increased with age, reaching a level of 20% in patients of the age group over 45 years. No differences in frequencies between genders were observed. The prevalence of IM had the highest increase, being 4-fold higher at the age of 65 years versus in individuals less than 45 years. CONCLUSION: The prevalence of gastritis featuring at risk for cancer development increases with age. These findings reinforce the necessity for the histological assessment, even in subjects with normal endoscopic appearance. The age-dependent increase in prevalence of severe histopathological changes in gastric mucosa, however, does not allow estimating the individual risk for gastric cancer development-only a proper follow-up can provide this information.
Characteristics of the Gastric Mucosa in Patients With Intestinal Metaplasia
Gastric intestinal metaplasia (IM) occurs in response to different injuries, some of which involve increased risk for gastric cancer, whereas others may not. The background in which IM arises has not been systematically investigated. This study was designed to determine the relative prevalence of the histopathologic conditions of the gastric mucosa associated with IM in a large cohort. We extracted from a database patients who had undergone esophagogastroduodenoscopy with gastric biopsies between January 2008 and December 2013 in endoscopy centers throughout the United States. For each subject we recorded demographic, clinical, and histopathologic information. We stratified patients according to the presence of IM and compared the prevalence of Helicobacter pylori infection, reactive gastropathy, minimal inflammatory and gastropathy changes, mucosal atrophy, gastric polyps, cancer, and lymphoma in the 2 groups. IM, present in 8.4% of the 810,821 unique patients, increased with age and was more common in male than in female individuals. Compared with other Americans, East Asian ancestry was associated with a 5-fold risk for IM. Helicobacter gastritis and its sequelae were present in 42.2% of patients with IM, and reactive gastropathy in 17.3%. In >50% of patients under the age of 30 and in 26% of older adults, foci of IM occurred in an almost normal gastric mucosa. Thus, approximately half of the patients with IM had no histopathologic evidence of current or previous Helicobacter gastritis, whereas almost one fifth had a background of reactive gastropathy. Longitudinal studies are needed to determine the relative risk for gastric cancer in patients with IM associated and not with Helicobacter infection.
Virchows Archiv, 2021
The use of Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis Assessment based on Intestinal Metaplasia (OLGIM) staging system is recommended for identifying subjects at risk for developing gastric cancer; usually high-risk lesions are considered only as stages III and IV. Accumulating evidence suggests that incomplete intestinal metaplasia (IM) is important in the development of gastric cancer. Our aim has been to identify the prevalence of incomplete IM in patients with low-risk OLGA/OLGIM stages among a high-risk general population. Healthy adult volunteers aged 40-64 years were invited to undergo upper endoscopy within a regional GISTAR pilot study in Kazakhstan (n = 166). Gastric lesions were staged according to OLGA/OLGIM staging system. High iron diamine-alcian blue (HID-AB) was used
From Gastric Inflammation to Gastric Cancer
Digestive Diseases, 2010
The majority of gastric adenocarcinomas are related to chronic inflammation induced by Helicobacter pylori infection. For intestinal-type gastric cancer, a multistep process of mucosal alterations leading from gastritis via glandular atrophy, intestinal metaplasia and dysplasia to invasive carcinoma is well recognized. Ongoing clinical studies focus on a 'point of no return'. It is defined as a situation when certain alterations are no longer reversible by H. pylori eradication and progression to gastric cancer may continue. H. pylori affects the mucosal as well as the systemic immune response by secretion of cytokines and the recruitment of distinct inflammatory cells. The immune response is characterized by a balance between a Th1-dominated response and the recruitment of antigen-specific regulatory T cells that allow the bacteria to persist in human gastric mucosa. Besides immune-mediated effects, H. pylori induces cellular alterations as well as genetic alterations in genes that are essential for the epigenetic integrity and mucosal homeostasis. These genetic alterations during gastric cancer development are in focus of intensive research and should ultimately allow the identification of risk factors involved in gastric carcinogenesis. The detection of individuals at high risk for gastric cancer would help to design appropriate strategies for prevention and surveillance.
Cancer Epidemiology, Biomarkers & Prevention, 2005
Family relatives of gastric cancer patients have a higher risk of gastric cancer and premalignant gastric lesions. We sought to determine the risk factors associated with the presence of intestinal metaplasia in a large cohort of gastric cancer relatives. First-degree relatives of gastric cancer patients were invited for screening gastroscopy. Endoscopic gastric biopsies were obtained from the antrum and corpus. Gastric biopsies were analyzed for Helicobacter pylori infection, severity of inflammation, and presence of intestinal metaplasia. Stepwise logistic regressions were used to identify for risk factors associated with presence of intestinal metaplasia in cancer relatives. Two hundred seventy cancer relatives underwent screening endoscopy (median age, 42; 47% male and 48% siblings). Among them, 161 (59.6%) were H. pylori positive and 81 (30%) had confirmed intestinal metaplasia. The following factors were found to be associated with the presence of intestinal metaplasia: age, m...