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Cited by 239Helicobacter pylori-related gastroenterology studiesGastric Cancer Management and OutcomesGastrointestinal Bleeding Diagnosis and Treatment

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Histologic intestinal metaplasia and endoscopic atrophy are predictors of gastric cancer development after Helicobacter pylori eradication

Shichijo, Satoki, Hirata, Yoshihiro, Niikura, Ryota, Hayakawa, Yoku, Yamada, Atsuo, Ushiku, Tetsuo, Fukayama, Masashi, Koike, Kazuhiko·2016·Gastrointestinal Endoscopy
DOI 10.1016/j.gie.2016.03.791
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Abstract

Background and aims Helicobacter pylori eradication therapy is effective at reducing the incidence of gastric cancer; however, gastric cancer still develops after eradication. We conducted a cohort study to elucidate the risk factors for gastric cancer development after successful H pylori eradication therapy. Methods From June 1998 to December 2012 we assessed histologic and endoscopic findings of gastritis and performed H pylori eradication therapy in 748 patients without a history of gastric cancer. Patients were classified according to the distribution of intestinal metaplasia (IM) as follows: no IM (IM group A), IM in the antrum only (IM group B), and IM in the corpus (IM group C). We assessed atrophy endoscopically according to the Kimura-Takemoto classification system. Gastric cancer incidence was assessed. Results A total of 573 patients underwent follow-up endoscopy; the mean duration of follow-up was 6.2 ± 4.8 years. Gastric cancer developed in 21 (20 intestinal type). The cumulative 5-year incidences of gastric cancer were 3.2% overall; 1.5%, 5.3%, and 9.8% in IM groups A, B, and C; and 0.7%, 1.9%, and 10% in the none/mild, moderate, and severe endoscopic atrophy groups, respectively. Compared with IM group A, the hazard ratio for IM group B was 3.6 (95% confidence interval [CI], 1.2-11), and that for IM group C was 3.7 (95% CI, 1.1-12). Compared with the none/mild endoscopic atrophy group, the hazard ratio for severe atrophy was 9.3 (95% CI, 1.7-174). Conclusions Patients with histologic IM or severe endoscopic atrophy were at increased risk of gastric cancer development after H pylori eradication.

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Metadata

Authors
Shichijo, S., Hirata, Y., Niikura, R., Hayakawa, Y., Yamada, A., Ushiku, T., Fukayama, M., & Koike, K.
Affiliations
The University of Tokyo (JP)
Corresponding author
Hirata, Yoshihiro
ORCID
Venue
Gastrointestinal Endoscopy
Publisher
Elsevier BV
Published
2016-10
Volume
84
Issue
4
Pages
618-624
ISSN
0016-5107 (ISSN-L)
DOI
10.1016/j.gie.2016.03.791
OpenAlex
W2300642250
Cited by
239
References
0
Citations by year
2026: 16 · 2025: 26 · 2024: 29 · 2023: 23 · 2022: 27 · 2021: 31 · 2020: 25 · 2019: 25 · 2018: 19 · 2017: 11 · 2016: 7
FWCI
22.92
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Gastrointestinal Endoscopy (publishedVersion)
  • PubMed (publishedVersion)
Funders
Japan Society for the Promotion of Science
Topics
  • Health Sciences › Medicine › Gastroenterology › Helicobacter pylori-related gastroenterology studies
  • Health Sciences › Medicine › Oncology › Gastric Cancer Management and Outcomes
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
Keywords
Helicobacter pylori eradication, gastric cancer risk, intestinal metaplasia, atrophic gastritis, gastric cancer incidence, risk factors, Kimura-Takemoto classification
MeSH terms
Aged, Amoxicillin, Anti-Bacterial Agents, Atrophy, Breath Tests, Female, Follow-Up Studies, Gastroscopy, Humans, Male, Metaplasia, Metronidazole, Middle Aged, Pyloric Antrum, Retrospective Studies, Risk Factors, Stomach, Stomach Neoplasms, Cohort Studies, Incidence, Proportional Hazards Models, Helicobacter pylori, Helicobacter Infections, Clarithromycin, Proton Pump Inhibitors, Lansoprazole

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