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• W2977722521 abstract "Purpose: Gastric carcinoma (GCA) is believed to arise via a process that includes chronic inflammation, atrophy, intestinal metaplasia, and finally dysplasia. Aim: To study the natural history of intestinal metaplasia of the stomach (IMS) and its associated risk of GCA in a Western population. Methods: A hospital database and electronic medical records were used to select adult patients who had EGD with gastric biopsy showing IMS from 1993 to 2012 at an academic tertiary-care center in Virginia. Patients with preexisting GCA and those diagnosed with GCA within 6 months following the index EGD were excluded. A control group included patients who had EGD with a normal gastric biopsy from 2002 to 2012. Pathology reports of all patients were reviewed. Patient demographics and H. pylori infection status were collected. ICD-9 codes from an institutional database were used to diagnose development of GCA. Last follow-up was either the last encounter at our institution or date of documented death. Results: Fourteen of 675 patients (2.1%) in the IMS group developed GCA, as compared to one patient of 1,273 (0.1%) in the control group (p<0.0001; Tables 1 and 2). Patients with IMS were older (61 vs. 44 years) and had longer follow-up (5.3 vs. 3.1 years). Only 17.5% of IMS patients had H. pylori on biopsy. On univariate analysis both IMS (HR 15.7;; 95% CI 2.00-122.81; p<0.009) and H. pylori infection (HR 3.4; 95% CI 1.02-1.099; p<0.05) were associated with increased risk for GCA. On multivariate analysis, of these factors: IMS, H. pylori, age, sex, and race, only IMS was associated with an increased risk for GCA (HR 11.23; 95% CI 1.35-93.40; p<0.025; Figure 1). The mean time interval between diagnoses of IMS and GCA was 4 years (SD 3.5 years).Table 1: Characteristics of patients with and without intestinal metaplasia of the stomachTable 2: Characteristics of patients with and without subsequent gastric cancerFigure 1: Kaplan-Meier curve demonstrating gastric-cancer-free survival (Y-axis) over time (X-axis) for patients with intestinal metaplasia of the stomach (green) vs. those without (blue).Conclusion: Western patients with IMS are at increased risk for GCA, and this risk may be increased by 11-fold in those with IMS. Given the relatively short time in which GCA develops in these patients following diagnosis of IMS, EGD for GCA surveillance at regular intervals should be considered." @default.
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• W2977722521 date "2013-10-01" @default.
• W2977722521 modified "2023-09-26" @default.
• W2977722521 title "Intestinal Metaplasia of the Stomach Is Associated with an Increased Risk of Gastric Cancer in a Western Population: ACG Governors Award for Excellence in Clinical Research" @default.
• W2977722521 doi "https://doi.org/10.14309/00000434-201310001-00154" @default.
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