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Gastroenterologie 26. April 2016

Relationship between atrophic gastritis, gastric intestinal metaplasia and Helicobacter pylori on endoscopic screening of upper gastrointestinal tract and a brief review of the literature

Endoscopic screening of upper gastrointestinal tract for gastric mucosal disorders

Objective: Gastric cancer mortality rates have been declining in Japan and Korea where gastric cancer is common, but mass screening programs are being conducted. However, this practice is difficult to implement in some countries with low gastric cancer incidence because of the expenses. Thus, the screening and following of high-risk patients should be performed at those countries where the patients entail high costs of time and money. The aim of our study is to determine the gastric cancer-related risk factors such as atrophic gastritis (AG) and intestinal metaplasia (IM), to identify high-risk patients in our region, to evaluate the relationship between the disease and Helicobacter pylori (H. pylori), as well as other risk factors and short-term results.

Patients and methods: Endoscopic, and histological biopsy results of 3096 patients, who had upper endoscopy because of upper gastrointestinal symptoms such as epigastric pain and dyspepsia, were retrospectively reviewed. All of these endoscopies had been performed between 2012 and 2014 in the endoscopy unit of our hospital.

Results: In total, 382 IM cases were found. A high correlation was observed between H. pylori positive patients and female gender (p = 0.02) and a significant association was detected between H. pylori negativity and IM (p = 0.001). While a high significant relation was revealed between female gender (p < 0.0001) and IM, a significant inverse relationship was detected between IM and AG (p = 0.001). The existence of H. pylori organism and being over the age of 40 were stated as significant risk factor for IM. After treatment of these patients, a significant decline was observed in IM.

Conclusion: Endoscopic diagnosis and histopathological verification of AG and IM, evaluating related risk factors, identifying high-risk patients, and inclusion of the individuals into treatment and screening programs are important in terms of preventive medicine.

M. Z. Üçüncü, E. Kabul Gürbulak, B. Gürbulak, O. A. Savaş, B. Özütürk, A. C. Dural, A. Haşlak, European Surgery 2/2016

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