Risk Factors for Gastric Tumorigenesis in Underlying Gastric Mucosal Atrophy
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Background/Aims: Atrophic gastritis is considered a premalignant lesion. We aimed to evaluate the risk factors for gastric tumorigenesis in underlying mucosal atrophy. Methods: A total of 10,185 subjects who underwent upper gastrointestinal endoscopy between 2003 and 2004 were enrolled in this retrospective cohort study. Follow-up endoscopy was performed between 2005 and 2014. Atrophic gastritis and intestinal metaplasia were assessed by endoscopy using the Kimura-Takemoto classification. Helicobacter pylori infection was evaluated based on serum immunoglobulin G antibody levels, the rapid urease test, or the urea breath test. Results: Atrophic gastritis was confirmed in 3,714 patients at baseline; 2,144 patients were followed up for 6.9 years, and 1,138 exhibited increased atrophy. A total of 69 subjects were diagnosed with gastric neoplasm during follow-up (35 adenoma and 34 carcinoma). Age ≥55 years (hazard ratio [HR], 1.234), alcohol consumption (HR, 1.001), and H. pylori infection (HR, 1.580) were associated with increased mucosal atrophy. The risk factors for gastric neoplasm in underlying mucosal atrophy were age ≥55 years (HR, 2.582), alcohol consumption (HR, 1.003), extent of mucosal atrophy (HR, 2.285 in C3-O1; HR, 4.187 in O2-O3), and intestinal metaplasia (HR, 2.655). Conclusions: Extent of atrophy, intestinal metaplasia, and alcohol consumption are significant risk factors for gastric neoplasm in underlying mucosal atrophy.
Abstract
Background/Aims: Atrophic gastritis is considered a premalignant lesion. We aimed to evaluate the risk factors for gastric tumorigenesis in underlying mucosal atrophy. Methods: A total of 10,185 subjects who underwent upper gastrointestinal endoscopy between 2003 and 2004 were enrolled in this retrospective cohort study. Follow-up endoscopy was performed between 2005 and 2014. Atrophic gastritis and intestinal metaplasia were assessed by endoscopy using the Kimura-Takemoto classification. Helicobacter pylori infection was evaluated based on serum immunoglobulin G antibody levels, the rapid urease test, or the urea breath test. Results: Atrophic gastritis was confirmed in 3,714 patients at baseline; 2,144 patients were followed up for 6.9 years, and 1,138 exhibited increased atrophy. A total of 69 subjects were diagnosed with gastric neoplasm during follow-up (35 adenoma and 34 carcinoma). Age ≥55 years (hazard ratio [HR], 1.234), alcohol consumption (HR, 1.001), and H. pylori infection (HR, 1.580) were associated with increased mucosal atrophy. The risk factors for gastric neoplasm in underlying mucosal atrophy were age ≥55 years (HR, 2.582), alcohol consumption (HR, 1.003), extent of mucosal atrophy (HR, 2.285 in C3-O1; HR, 4.187 in O2-O3), and intestinal metaplasia (HR, 2.655). Conclusions: Extent of atrophy, intestinal metaplasia, and alcohol consumption are significant risk factors for gastric neoplasm in underlying mucosal atrophy.
참고문헌 (25)
- Correa P, "Human gastric carcinogenesis: a multistep and multifactorial process--first American Cancer Society award lecture on cancer epidemiology and prevention", Cancer Res, 52, pp.6735~6740 (1992)
- Watari J, "Helicobacter pylori associated chronic gastritis, clinical syndromes, precancerous lesions, and pathogenesis of gastric cancer development.", World J Gastroenterol, 20, pp.5461~5473 (2014)
- de Vries AC, "The detection, surveillance and treatment of premalignant gastric lesions related to Helicobacter pylori infection", Helicobacter, 12, pp.1~15 (2007)
- Karimi P, "Gastric cancer: descriptive epidemiology, risk factors, screening, and prevention", Cancer Epidemiol Biomarkers Prev, 23, pp.700~713 (2014)
- Ferlay J, "Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008", Int J Cancer, 127, pp.2893~2917 (2010)
- Forman D, "Gastric cancer: global pattern of the disease and an overview of environmental risk factors", Best Pract Res Clin Gastroenterol, 20, pp.633~649 (2006)
- Anderson WF, "Age-specific trends in incidence of noncardia gastric cancer in US adults", JAMA, 303, pp.1723~1728 (2010)
- Song H, "Increase in the prevalence of atrophic gastritis among adults age 35 to 44 years old in Northern Sweden between 1990 and 2009", Clin Gastroenterol Hepatol, 13, pp.1592~1600 (2015)
- Song H, "Incidence of gastric cancer among patients with gastric precancerous lesions: observational cohort study in a low risk Western population", BMJ, 351, pp.h3867~ (2015)
- 주영은, "Prevalence and Risk Factors of Atrophic Gastritis and Intestinal Metaplasia: A Nationwide Multicenter Prospective Study in Korea", Gut and Liver, 7(3), pp.303~310 (2013), 거트앤리버 발행위원회
- 이경숙, "Gastric Cancer Screening in Korea: Report on the National Cancer Screening Program in 2008", Cancer Research and Treatment, 43(2), pp.83~88 (2011), 대한암학회
- Chung SJ, "Effect of annual endoscopic screening on clinicopathologic characteristics and treatment modality of gastric cancer in a high-incidence region of Korea", Int J Cancer, 131, pp.2376~2384 (2012)
- Yoon H, "Effect of endoscopic screening at 1-year intervals on the clinicopathologic characteristics and treatment of gastric cancer in South Korea", J Gastroenterol Hepatol, 27, pp.928~934 (2012)
- Kimura K, "An endoscopic recognition of the atrophic border and its significance in chronic gastritis", Endoscopy, 3, pp.87~97 (1969)
- Masuyama H, "Relationship between the degree of endoscopic atrophy of the gastric mucosa and carcinogenic risk", Digestion, 91, pp.30~36 (2015)
- Chen HN, "Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis", Gastric Cancer, 19, pp.166~175 (2016)
- Ohata H, "Progression of chronic atrophic gastritis associated with Helicobacter pylori infection increases risk of gastric cancer", Int J Cancer, 109, pp.138~143 (2004)
- Wu CY, "Early Helicobacter pylori eradication decreases risk of gastric cancer in patients with peptic ulcer disease", Gastroenterology, 137, pp.1641~1648.e2 (2009)
- Wong BC, "Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial", JAMA, 291, pp.187~194 (2004)
- 이주엽, "Correlations Among Endoscopic, Histologic and Serologic Diagnoses for the Assessment of Atrophic Gastritis", 대한암예방학회지, 19(1), pp.47~55 (2014), 대한암예방학회
- Yo Han Park, "Review of Atrophic Gastritis and Intestinal Metaplasia as a Premalignant Lesion of Gastric Cancer", 대한암예방학회지, 20(1), pp.25~40 (2015), 대한암예방학회[DOI]
- Huang YK, "Significance of serum pepsinogens as a biomarker for gastric cancer and atrophic gastritis screening: a systematic review and meta-analysis.", PLoS One, 10, pp.e0142080~ (2015)
- Kim EH, "The optimal serum pepsinogen cut-off value for predicting histologically confirmed atrophic gastritis", Dig Liver Dis, 47, pp.663~668 (2015)
- Park YM, "Clinical risk assessment for gastric cancer in asymptomatic population after a health check-up: an individualized consideration of the risk factors", Medicine (Baltimore), 95, pp.e5351~ (2016)
- IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, "Alcohol consumption and ethyl carbamate", IARC Monogr Eval Carcinog Risks Hum, 96, pp.3~1383 (2010)