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The gastric mucosa in gastric cancer patients in a low-incidence area.
Eur J Gastroenterol Hepatol. 2006 Oct; 18(10):1085-93.EJ

Abstract

BACKGROUND AND AIMS

Atrophic gastritis, intestinal metaplasia, and pyloric metaplasia are frequent precursors of noncardial intestinal-type gastric adenocarcinoma in populations in which both gastric cancer and Helicobacter pylori infection are common. We hypothesized that such lesions would be less prevalent in European gastric cancer patients.

METHODS

Slides from patients who underwent gastrectomy for adenocarcinoma between 1997 and 2004 were reviewed. Tumors were categorized as intestinal or diffuse; non-neoplastic mucosa was evaluated for gastritis, atrophy, intestinal metaplasia and pyloric metaplasia.

RESULTS

We studied 81 patients: 48 Swiss (mean age 68.5 years); 17 Italians (mean age 67.8 years); and 16 Iberians (mean age 54.8 years; P<0.001). Twelve tumors were proximal (all intestinal type), 12 in the corpus (six intestinal-type), and 57 antral (30 intestinal type). Patients with diffuse cancers were younger than those with intestinal type (P<0.05). Nineteen patients (23.4%) had a normal stomach; 30% of T1 tumors and 90% of T4s arose in a normal stomach (P<0.02). H. pylori gastritis was found in 47 patients (58%); they did not differ in age, sex, national origin, cancer location or type from those without gastritis. Intestinal metaplasia correlated with H. pylori gastritis (P=0.002). Pyloric metaplasia was infrequent and limited to rare microfoci.

CONCLUSIONS

A quarter of the patients had a normal stomach, and pyloric metaplasia was distinctly uncommon. Approaches to prevention and early detection of gastric cancer based on bioptic or serological demonstration of atrophy and metaplasia could overlook at least 25% of the people at risk in certain populations and may need to be adapted to local conditions.

Authors+Show Affiliations

Pathology & Laboratory Service, University of Texas Southwestern Medical Center, Dallas 75216, USA. robert.genta@utsouthwestern.eduNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16957515

Citation

Genta, Robert M., and Marc Pusztaszeri. "The Gastric Mucosa in Gastric Cancer Patients in a Low-incidence Area." European Journal of Gastroenterology & Hepatology, vol. 18, no. 10, 2006, pp. 1085-93.
Genta RM, Pusztaszeri M. The gastric mucosa in gastric cancer patients in a low-incidence area. Eur J Gastroenterol Hepatol. 2006;18(10):1085-93.
Genta, R. M., & Pusztaszeri, M. (2006). The gastric mucosa in gastric cancer patients in a low-incidence area. European Journal of Gastroenterology & Hepatology, 18(10), 1085-93.
Genta RM, Pusztaszeri M. The Gastric Mucosa in Gastric Cancer Patients in a Low-incidence Area. Eur J Gastroenterol Hepatol. 2006;18(10):1085-93. PubMed PMID: 16957515.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The gastric mucosa in gastric cancer patients in a low-incidence area. AU - Genta,Robert M, AU - Pusztaszeri,Marc, PY - 2006/9/8/pubmed PY - 2007/9/28/medline PY - 2006/9/8/entrez SP - 1085 EP - 93 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 18 IS - 10 N2 - BACKGROUND AND AIMS: Atrophic gastritis, intestinal metaplasia, and pyloric metaplasia are frequent precursors of noncardial intestinal-type gastric adenocarcinoma in populations in which both gastric cancer and Helicobacter pylori infection are common. We hypothesized that such lesions would be less prevalent in European gastric cancer patients. METHODS: Slides from patients who underwent gastrectomy for adenocarcinoma between 1997 and 2004 were reviewed. Tumors were categorized as intestinal or diffuse; non-neoplastic mucosa was evaluated for gastritis, atrophy, intestinal metaplasia and pyloric metaplasia. RESULTS: We studied 81 patients: 48 Swiss (mean age 68.5 years); 17 Italians (mean age 67.8 years); and 16 Iberians (mean age 54.8 years; P<0.001). Twelve tumors were proximal (all intestinal type), 12 in the corpus (six intestinal-type), and 57 antral (30 intestinal type). Patients with diffuse cancers were younger than those with intestinal type (P<0.05). Nineteen patients (23.4%) had a normal stomach; 30% of T1 tumors and 90% of T4s arose in a normal stomach (P<0.02). H. pylori gastritis was found in 47 patients (58%); they did not differ in age, sex, national origin, cancer location or type from those without gastritis. Intestinal metaplasia correlated with H. pylori gastritis (P=0.002). Pyloric metaplasia was infrequent and limited to rare microfoci. CONCLUSIONS: A quarter of the patients had a normal stomach, and pyloric metaplasia was distinctly uncommon. Approaches to prevention and early detection of gastric cancer based on bioptic or serological demonstration of atrophy and metaplasia could overlook at least 25% of the people at risk in certain populations and may need to be adapted to local conditions. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/16957515/The_gastric_mucosa_in_gastric_cancer_patients_in_a_low_incidence_area_ DB - PRIME DP - Unbound Medicine ER -