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MINERVA GASTROENTEROLOGICA E DIETOLOGICA
A Journal on Gastroenterology, Nutrition and Dietetics
Indexed/Abstracted in: CAB, EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index
FIRST WORKSHOP ON HELICOBACTER PYLORI
Minerva Gastroenterologica e Dietologica 2002 June;48(2):169-74
Gastric carcinoma risk index, type III intestinal metaplasia and Helicobacter pylori status on antrum and body biopsies in a prospective general population study
Venturini I., Taraglio S., Mazzucco D., Camellini L., Cardesi E., Suriani R.
Background. To evaluate the utility of 2 biopsies of antrum and gastric body on routinary endoscopy for the assessment of type III intestinal metaplasia (IM-3) and Helicobacter pylori (Hp) status, 1750 patients (pts) (895 males and 855 females, mean age 60.2) were considered from June 1998 to June 2000.
Methods. Specimens were graded 0 to 3 for atrophy, IM-3 and Hp status. 620 pts treated previously with antibiotics or not eligible for biopsy were excluded from initial 2360 pts.
Results. IM-3 (score >0), was found in 118 pts (6.7%), 86 pts (4.9%) only in the antrum. Ten of 355 pts (2.8%) with normal endoscopy findings and 47 of 702 (6.6%) with non erosive endoscopic gastritis resulted IM-3 positive in the antrum. 709 pts (40.5%) were found positive for Hp in antrum or/and corpus. The presence of Hp and IM-3 in the antrum was not correlated (p=0.99; spearman test). A positive correlation (p=0.000) between duodenal ulcer and Hp was found when antral Hp positivity was taken into account. Gastric carcinoma risk index (GCRI) was found in 358 pts (20.4%); in this group 131 pts (36.6%) were Hp positive, 82 pts (23%) have IM-3, 184 pts (51.4%) have atrophy.
Conclusions. The incidence of IM-3 is low (6.7%) in routinary endoscopy. Normal endoscopy does not exclude the presence of IM-3. The biopsy is necessary to discover IM-3 in the antrum in 5.3% of pts with normal or aspecific endoscopic gastritis. Application of the GCRI might be useful to identify a group of patients carrying a higher risk for gastric carcinoma.