Endoscopic atrophic classification before and after H. pylori eradication is closely associated with histological atrophy and intestinal metaplasia.
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A total of 230 patients (137 males, 93 females; mean age: 58.0 ± 11.8 y) with successful eradication were enrolled.The mean IM scores before and after eradication were 0.55 and 0.47 at the antrum (P = 0.154), and 0.09 and 0.05 at the corpus (P = 0.096), respectively.EAC may be beneficial in evaluating the risk of gastric cancer after H. pylori eradication.
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PubMed Central - PubMed
Affiliation: Institution Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.
ABSTRACT
Background and study aims: The relationship between endoscopic atrophy classification (EAC) and histological gastric atrophy and intestinal metaplasia (IM) was examined before and after Helicobacter pylori (H. pylori) eradication in order to evaluate the usefulness of EAC for detecting the risk of gastric cancer following eradication. Patients and methods: A total of 230 patients (137 males, 93 females; mean age: 58.0 ± 11.8 y) with successful eradication were enrolled. EAC score was defined as follows: C0(none): 0, C1: 1, C2: 2, C3: 3, O1: 4, O2: 5, and O3(severe): 6. Histological atrophy and IM score (0 to 3) from the antrum and the corpus were evaluated with updated Sydney system for histological atrophy and IM. Results: The mean EAC scores were 3.46 before eradication and 3.20 after eradication (P = 0.026). The mean atrophy scores before and after eradication were 1.45 and 0.92 at the antrum (P < 0.001) and 0.50 and 0.07 at the corpus (P < 0.001), respectively. The mean IM scores before and after eradication were 0.55 and 0.47 at the antrum (P = 0.154), and 0.09 and 0.05 at the corpus (P = 0.096), respectively. The histological atrophy scores showed significant improvement after eradication, while IM showed no significant change. The Mantel-Haenszel test for trend indicated there was a significant correlation between EAC and histological atrophy and IM, except antral atrophy after eradication. Conclusions: EAC exhibited a significant correlation between histological atrophy and IM, and represents a noninvasive classification method. EAC may be beneficial in evaluating the risk of gastric cancer after H. pylori eradication. No MeSH data available. Related in: MedlinePlus |
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Mentions: The P-value for the Mantel-Haenszel test for trend was 0.008 before eradication and 0.069 after eradication at the antrum, and was 0.004 before eradication and 0.031 after eradication at the corpus. The trend in EAC and histological atrophy was significant before eradication and after eradication, except at the antrum after eradication (Fig. 5 a, b). At the antrum, the histological IM scores before and after eradication for each endoscopic grade were: C1: 0.21and 0.21 (P = 0.50); C2: 0.31and 0.26 (P = 0.35); C3: 0.72 and 0.47 (P = 0.11); O1: 0.56 and 0.59 (P = 0.43); O2: 0.73 and 0.69 (P = 0.45); O3: 0.90 and 1.10 (P = 0.32), respectively (Fig. 6 a). At the corpus, the histological IM scores before and after eradication for each endoscopic grade were: C1: 0.00 and 0.05 (P = 0.17); C2: 0.02 and 0.00 (P = 0.16); C3: 0.08 and 0.00 (P = 0.092); O1: 0.09 and 0.06 (P = 0.38); O2: 0.18 and 0.08 (P = 0.18), O3: 0.26 and 0.50 (P = 0.27), respectively (Fig. 6 b). None of the IM scores after eradication for any of EAC levels exhibited any significant improvement at both the antrum and the corpus. The P-value for the Mantel-Haenszel test for trend was 0.005 before eradication and < 0.0001 after eradication at the antrum, and 0.048 before eradication and 0.027 after eradication at the corpus. EAC and histological IM showed a significant trend both before and after eradication (Fig. 6 a, b). |
View Article: PubMed Central - PubMed
Affiliation: Institution Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan.
Background and study aims: The relationship between endoscopic atrophy classification (EAC) and histological gastric atrophy and intestinal metaplasia (IM) was examined before and after Helicobacter pylori (H. pylori) eradication in order to evaluate the usefulness of EAC for detecting the risk of gastric cancer following eradication.
Patients and methods: A total of 230 patients (137 males, 93 females; mean age: 58.0 ± 11.8 y) with successful eradication were enrolled. EAC score was defined as follows: C0(none): 0, C1: 1, C2: 2, C3: 3, O1: 4, O2: 5, and O3(severe): 6. Histological atrophy and IM score (0 to 3) from the antrum and the corpus were evaluated with updated Sydney system for histological atrophy and IM.
Results: The mean EAC scores were 3.46 before eradication and 3.20 after eradication (P = 0.026). The mean atrophy scores before and after eradication were 1.45 and 0.92 at the antrum (P < 0.001) and 0.50 and 0.07 at the corpus (P < 0.001), respectively. The mean IM scores before and after eradication were 0.55 and 0.47 at the antrum (P = 0.154), and 0.09 and 0.05 at the corpus (P = 0.096), respectively. The histological atrophy scores showed significant improvement after eradication, while IM showed no significant change. The Mantel-Haenszel test for trend indicated there was a significant correlation between EAC and histological atrophy and IM, except antral atrophy after eradication.
Conclusions: EAC exhibited a significant correlation between histological atrophy and IM, and represents a noninvasive classification method. EAC may be beneficial in evaluating the risk of gastric cancer after H. pylori eradication.
No MeSH data available.