Carlos A González1, José Miguel Sanz-Anquela2, Osmel Companioni1, Catalina Bonet1, María Berdasco3, Consuelo López4, Jorge Mendoza5, M Dolores Martín-Arranz6, Enrique Rey7, Elvira Poves8, Laura Espinosa8, Jesús Barrio9, M Ángeles Torres10, Miriam Cuatrecasas11, Ignasi Elizalde12, Luis Bujanda13, Maddi Garmendia13, Ángel Ferrández9, Guillermo Muñoz14, Victoria Andreu15, M Jose Paules16, Sergio Lario17, M Jose Ramírez17, Javier P Gisbert5. 1. Unit of Nutrition, Environment and Cancer, Institut Català d'Oncología, Barcelona, Spain. 2. University of Alcalá (Department of Medicine and Medical Especialties), Department of Pathology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain. 3. Cancer Epigenetics and Biology Program, IDIBELL, Barcelona. 4. Department of Pathology, Hospital Universitario de la Princesa, IIS-IP, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid. 5. Department of Gastroenterology, Hospital Universitario de la Princesa, IIS-IP, and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid. 6. Department of Gastroenterology, Hospital Universitario La Paz, Madrid. 7. Department of Gastroenterology, Hospital Clínico San Carlos, Madrid, Spain. 8. Department of Gastroenterology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares. 9. Department of Gastroenterology, Hospital Universitario Río Hortega, Valladolid, Spain. 10. Department of Pathology, Hospital Universitario Río Hortega, Valladolid, Spain. 11. Department of Pathology, Hospital Clínic de Barcelona, IDIBAPS and CIBEREHD, and Universitat de Barcelona, Spain. 12. Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS and CIBEREHD, Spain. 13. Department of Pathology, and Department of Gastroenterology. Hospital Donostia/Instituto Biodonostia, Universidad del País Vasco (UPV/EHU). CIBEREHD, San Sebastián, Spain. 14. Department of Pathology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, and CIBEREHD, Spain. 15. Department of Gastroenterology, Hospital de Viladecans, Spain. 16. Department of Pathology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain. 17. Departament of Medicine, Digestive Diseases Service, Institut Universitari Parc Taulí, Sabadell, and CIBEREHD, Spain.
Abstract
BACKGROUND AND AIM: In high or moderate risk populations, periodic surveillance of patients at risk of progression from gastric precursor lesions (PL) to gastric cancer (GC) is the most effective strategy for reducing the burden of GC. Incomplete type of intestinal metaplasia (IIM) may be considered as the best candidate, but it is still controversial and more research is needed. To further assess the progression of subtypes of IM as predictors of GC occurrence. METHODS: A follow-up study was carried-out including 649 patients, diagnosed with PL between 1995-2004 in 9 participating hospitals from Spain, and who repeated the biopsy during 2011-2013. Medical information and habits were collected through a questionnaire. Based on morphology, IM was sub-classified as complete (small intestinal type, CIM) and incomplete (colonic type, IIM). Analyses were done using Cox (HR) models. RESULTS: At baseline, 24% of patients had atrophic gastritis, 38% CIM, 34% IIM, and 4% dysplasia. Mean follow-up was 12 years. 24 patients (3.7%) developed a gastric adenocarcinoma during follow-up. The incidence rate of GC was 2.76 and 5.76 per 1,000 person-years for those with CIM and IIM, respectively. The HR of progression to CG was 2.75 (95% CI 1.06-6.26) for those with IIM compared with those with CIM at baseline, after adjusting for sex, age, smoking, family history of GC and use of NSAIDs. CONCLUSIONS: IIM is the PL with highest risk to progress to GC. Sub-typing of IM is a valid procedure for the identification of high risk patients that require more intensive surveillance.
BACKGROUND AND AIM: In high or moderate risk populations, periodic surveillance of patients at risk of progression from gastric precursor lesions (PL) to gastric cancer (GC) is the most effective strategy for reducing the burden of GC. Incomplete type of intestinal metaplasia (IIM) may be considered as the best candidate, but it is still controversial and more research is needed. To further assess the progression of subtypes of IM as predictors of GC occurrence. METHODS: A follow-up study was carried-out including 649 patients, diagnosed with PL between 1995-2004 in 9 participating hospitals from Spain, and who repeated the biopsy during 2011-2013. Medical information and habits were collected through a questionnaire. Based on morphology, IM was sub-classified as complete (small intestinal type, CIM) and incomplete (colonic type, IIM). Analyses were done using Cox (HR) models. RESULTS: At baseline, 24% of patients had atrophic gastritis, 38% CIM, 34% IIM, and 4% dysplasia. Mean follow-up was 12 years. 24 patients (3.7%) developed a gastric adenocarcinoma during follow-up. The incidence rate of GC was 2.76 and 5.76 per 1,000 person-years for those with CIM and IIM, respectively. The HR of progression to CG was 2.75 (95% CI 1.06-6.26) for those with IIM compared with those with CIM at baseline, after adjusting for sex, age, smoking, family history of GC and use of NSAIDs. CONCLUSIONS: IIM is the PL with highest risk to progress to GC. Sub-typing of IM is a valid procedure for the identification of high risk patients that require more intensive surveillance.
Authors: David K van der Poorten; Duncan McLeod; Golo Ahlenstiel; Scott Read; Avelyn Kwok; Cositha Santhakumar; Milan Bassan; Suzanne Culican; David Campbell; Sue W J Wong; Louise Evans; Bilel Jideh; Alisa Kane; Constance H Katelaris; Karuna Keat; Yanna Ko; Jessie A Lee; Sandhya Limaye; Ming Wei Lin; Ari Murad; Martina Rafferty; Dan Suan; Sanjay Swaminathan; Sean D Riminton; Catherine Toong; Lucinda J Berglund Journal: J Clin Immunol Date: 2018-09-15 Impact factor: 8.317
Authors: Katherine M Riera; Bogun Jang; Jimin Min; Joseph T Roland; Qing Yang; William T Fesmire; Sophie Camilleri-Broet; Lorenzo Ferri; Woo H Kim; Eunyoung Choi; James R Goldenring Journal: J Pathol Date: 2020-06-15 Impact factor: 7.996
Authors: Matthew Banks; David Graham; Marnix Jansen; Takuji Gotoda; Sergio Coda; Massimiliano di Pietro; Noriya Uedo; Pradeep Bhandari; D Mark Pritchard; Ernst J Kuipers; Manuel Rodriguez-Justo; Marco R Novelli; Krish Ragunath; Neil Shepherd; Mario Dinis-Ribeiro Journal: Gut Date: 2019-07-05 Impact factor: 23.059
Authors: Robertino M Mera; Luis E Bravo; M Constanza Camargo; Juan C Bravo; Alberto G Delgado; Judith Romero-Gallo; Maria C Yepez; José L Realpe; Barbara G Schneider; Douglas R Morgan; Richard M Peek; Pelayo Correa; Keith T Wilson; M Blanca Piazuelo Journal: Gut Date: 2017-06-24 Impact factor: 23.059
Authors: M Blanca Piazuelo; Luis E Bravo; Robertino M Mera; M Constanza Camargo; Juan C Bravo; Alberto G Delgado; M Kay Washington; Alicia Rosero; Luz S Garcia; Jose L Realpe; Sandra P Cifuentes; Douglas R Morgan; Richard M Peek; Pelayo Correa; Keith T Wilson Journal: Gastroenterology Date: 2020-11-18 Impact factor: 22.682
Authors: William Waddingham; Stella A V Nieuwenburg; Sean Carlson; Manuel Rodriguez-Justo; Manon Spaander; Ernst J Kuipers; Marnix Jansen; David G Graham; Matthew Banks Journal: Frontline Gastroenterol Date: 2020-07-30