Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia.

World J Gastrointest Endosc 2017 Feb;9(2):61-69

Justin M Gomez, Wissam Bleibel, Jeanetta W Frye, Bryan G Sauer, Vanessa M Shami, Andrew Y Wang, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA 22908, United States.

Aim: To determine which clinical factors might be associated with gastric intestinal metaplasia (IM) in a North American population.

Methods: Pathology and endoscopy databases at an academic medical center were reviewed to identify patients with and without gastric IM on biopsies for a retrospective cohort study. Patient demographics, insurance status, and other clinical factors were reviewed.

Results: Four hundred and sixty-eight patients with gastric IM (mean age: 61.0 years ± 14.4 years, 55.5% female) and 171 without gastric IM (mean age: 48.8 years ± 20.8 years, 55.0% female) were compared. The endoscopic appearance of atrophic gastritis correlated with finding gastric IM on histopathology (OR = 2.05, = 0.051). Gastric IM was associated with histologic findings of chronic gastritis (OR = 2.56, < 0.001), gastric ulcer (OR = 6.97, = 0.015), gastric dysplasia (OR = 6.11, = 0.038), and gastric cancer (OR = 6.53, = 0.027). Histologic findings of Barrett's esophagus (OR = 0.28, = 0.003) and esophageal dysplasia (OR = 0.11, = 0.014) were inversely associated with gastric IM. Tobacco use (OR = 1.73, = 0.005) was associated with gastric IM.

Conclusion: Patients who smoke or have the endoscopic finding of atrophic gastritis are more likely to have gastric IM and should have screening gastric biopsies during esophagogastroduodenoscopy (EGD). Patients with gastric IM are at increased risk for having gastric dysplasia and cancer, and surveillance EGD with gastric biopsies in these patients might be reasonable.

Download full-text PDF

Source
http://dx.doi.org/10.4253/wjge.v9.i2.61DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5311474PMC
February 2017
17 Reads

Publication Analysis

Top Keywords

gastric
18
associated gastric
16
gastric dysplasia
12
gastric biopsies
12
patients gastric
12
clinical factors
8
esophageal dysplasia
8
gastric intestinal
8
gastric age
8
histologic findings
8
intestinal metaplasia
8
atrophic gastritis
8
associated
5
dysplasia
5
patients
5
gastritis 256
4
256 0001
4
findings chronic
4
associated histologic
4
chronic gastritis
4

Similar Publications