First endoscopic-histologic follow-up in patients with body-predominant atrophic gastritis: when should it be done?

Gastrointest Endosc. 2001 Apr;53(4):443-8. doi: 10.1067/mge.2001.112189.

Abstract

Background: Body-predominant atrophic gastritis is considered a risk factor for gastric cancer and carcinoid. Timing of follow-up for patients with this disorder has not been defined. This study was undertaken to determine the optimal time for the first endoscopic/histologic follow-up in patients with body-predominant atrophic gastritis.

Methods: Forty-two patients with body-predominant atrophic gastritis were randomly assigned to 1 of 2 follow-up intervals: group A (n = 22) at 24 months and group B (n = 20) at 48 months. At baseline and follow-up patients underwent gastroscopy at which biopsies were obtained from the antrum and body for histopathology and evaluation for enterochromaffin-like cells.

Results: In group A patients, 2 antral hyperplastic polyps (9.1%) were present at baseline and 4 antral hyperplastic polyps (18.2%) were found at follow-up. In group B patients, baseline gastroscopy revealed 2 antral hyperplastic polyps (10%) and follow-up 2 antral hyperplastic polyps (10%) and 1 carcinoid tumor (5%) in the body. Atrophy and intestinal metaplasia scores in gastric body and antral mucosa in both groups did not change significantly between baseline and follow-up, except an increase in antral mucosa atrophy in group B patients (p = 0.02) was revealed.

Conclusions: The results of this study indicate that performing the first follow-up in patients with body-predominant atrophic gastritis need not be earlier than at 4 years after diagnosis. This interval is satisfactory for detection of potential neoplastic lesions.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anemia, Pernicious / diagnosis
  • Biopsy
  • Carcinoid Tumor / complications
  • Carcinoid Tumor / diagnosis*
  • Carcinoid Tumor / pathology
  • Enterochromaffin-like Cells
  • Female
  • Follow-Up Studies
  • Gastric Mucosa
  • Gastrins / analysis
  • Gastritis, Atrophic / complications*
  • Gastroscopy / methods*
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Pepsinogen A / analysis
  • Polyps / diagnosis
  • Prospective Studies
  • Pyloric Antrum
  • Random Allocation
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / diagnosis*
  • Stomach Neoplasms / pathology
  • Time Factors

Substances

  • Gastrins
  • Pepsinogen A