Comparison of intestinal metaplasia and Helicobacter pylori positivity in patients from different age groups with antral gastritis

Year 2021, , 226 - 229, 01.03.2021

Ugur Kesıcı , Gökmen Öztürk , Sevgi Kesici , Atilla Yılmaz

https://doi.org/10.28982/josam.747328

Abstract

Background/Aim: Gastric carcinoma (GC) is the fourth most common cancer worldwide and the second most common cause of cancer death. Primary prevention for GC includes healthy diet, eradication of Helicobacter pylori (HP), chemoprevention and early diagnosis. For this reason, finding out the HP incidence in patients with suspected antral gastritis in various age groups can lead to forming a treatment strategy to prevent development of GC. The aim of this study is to find out the HP incidence in patients with a proven antral gastritis diagnosis in various age groups and form different treatment strategies.
Methods: This study included 1589 patients aged between 15-91 years who underwent diagnostic upper gastrointestinal endoscopy due to complaints of dyspepsia. The demographic characteristics, such as age and sex, and histopathological HP score (HPS) and IM score (IMS) were recorded. The patients were divided into three groups according to age: 15-29 years, 30-64 years, and 65 years and above.
Results: In the 15–29-year age group, IM positivity was significantly lower and HP positivity was significantly higher compared to other age groups (P<0.01). In the age group of 65 years and above, HP positivity was significantly lower than in the other groups (P<0.01). The incidence of IM was significantly higher and that of HP was significantly lower in male patients aged 65 years and older (P<0.01 for both). IM positivity was significantly higher in HP negative patients than in HP positive patients (P=0.02).
Conclusion: The most important risk factors for the development of IM are male gender and being aged 65 years and older. HP positivity is higher among the young population and IM prevalence is higher in advanced ages. There is no correlation between HP positivity and the presence of IM.

Keywords

Endoscopy, gastrointestinal system, intestinal metaplasia, Helicobacter pylori

References

• 1. Sitarz R, Skierucha M, Mielko J, Offerhaus GJA, Maciejewski R, Polkowski WP. Gastric cancer: epidemiology, prevention, classification, and treatment. Cancer Manag Res. 2018;10:239–48.
• 2. Kesici U. Comparison of intestinal metaplasia and Helicobacter pylori scores in patients undergoing upper gastrointestinal endoscopy. Cukurova Med J. 2018;43:574-80.
• 3. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Lyon, 7–14 June 1994. Schistosomes, liver flukes and Helicobacter pylori. IARC Monogr Eval Carcinog Risks Hum. 1994;61:1–241.
• 4. Malfertheiner P, Megraud F, O'Morain C, Bazzoli F, El-Omar E, Graham D, et al. Current concepts in the management of Helicobacter pyloriinfection: the Maastricht III Consensus Report. Gut. 2007;56:772–81.
• 5. Sugimoto M, Ban H, Ichikawa H, Sahara S, Otsuka T, Inatomi O, et al. Efficacy of the Kyoto classification of gastritis in identifying patients at high risk for gastric cancer. Intern Med. 2017;56:579-86.
• 6. Özer Etik D, Turhan N. Gastrik intestinal metaplaziye gastroenterolog ve patolog gözü ile bakış. Güncel Gastroenteroloji. 2016;20:375-82.
• 7. Yoon H, Kim N. Diagnosis and management of the high risk group for gastric cancer. Gut Liver. 2015;9:5-17.
• 8. Büyükbayram H, Uzunlar AK, Yılmaz F, Yaldız M, Dursun M, Arslan A. Histological evaluation of gastric biopsies according to sydney system. Turkish Journal of Pathology. 2000:16;116-20.
• 9. Craanen ME, Dekker W, Blok P, Ferwerda J, Tytgat GNJ. Intestinal metaplasia and H.Pylori: An endoscopic bioptic study of the gastric antrum. Gut. 1992;33:16-20.
• 10. Wang J, Xu L, Shi R, Huang X, Li SW, Huang Z, et al. Gastric atrophy and intestinal metaplasia before and after Helicobacter pylori eradication: a metaanalysis. Digestion. 2011;83:253-60.
• 11. Fuccio L, Zagari RM, Eusebi LH, Laterza L, Cennamo V, Ceroni L, et al. Meta-analysis: can Helicobacter pylori eradication treatment reduce the risk for gastric cancer? Ann Intern Med. 2009;151:121-8.
• 12. Wong BC, Lam SK, Wong WM, Chen JS, Zheng TT, Feng RE, et al. Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA. 2004;291:187-94.
• 13. Kodama M, Murakami K, Okimoto T, Abe T, Nakagawa Y, Mizukami, K et al. Helicobacter pylori eradication improves gastric atrophy and intestinal metaplasia in long-term observation. Digestion. 2012;85:126-30.
• 14. Kang JM, Kim N, Shin CM, Lee HS, Lee DH, Jung HC, et al. Predictive factors for improvement of atrophic gastritis and intestinal metaplasia after Helicobacter pylori eradication: a three-year followup study in Korea. Helicobacter. 2012;17:86-95.
• 15. Rokkas T, Rokka A, Portincasa P. A systematic review and meta-analysis of the role of Helicobacter pylori eradication in preventing gastric cancer. Ann Gastroenterol. 2017;30:414-23.
• 16. Hwang YJ, Kim N, Lee HS, Lee JB, Choi YJ, Yoon H, et al. Reversibility of atrophic gastritis and intestinal metaplasia after Helicobacter pylori eradication - a prospective study for up to 10 years. Aliment Pharmacol Ther. 2018;47:380-90.
• 17. Ozdil K, Sahin A, Kahraman R, Yuzbasioglu B, Demirdag H, Calhan T, et al. Current prevalence of intestinal metaplasia and Helicobacter pylori infection in dyspeptic adult patients from Turkey. Hepatogastroenterology. 2010;57:1563-6.
• 18. Ajdarkosh H, Sohrabi M, Moradniani M, Rakhshani N, Sotodeh M, Hemmasi G, et al. Prevalence of gastric precancerous lesions among chronic dyspeptic patients and related common risk factors. Eur J Cancer Prev. 2015;24:400-6.
• 19. Jiang JX, Liu Q, Zhao B, Zhang HH, Sang HM, Djaleel SM, et al. Risk factors for intestinal metaplasia in a southeastern Chinese population: an analysis of 28,745 cases. J Cancer Res Clin Oncol. 2017;143:409-18.
• 20. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784-9.
• 21. Topal D, Göral V, Yılmaz F. Helicobacter pylori’nin intestinal metaplazi, gastrik atrofi ve Bcl-2 ile ilişkisi. Turkiye Klinikleri J Gastroenterohepatol. 2004;15:65-73.