First endoscopic-histologic follow-up in patients with body-predominant atrophic gastritis: when should it be done?
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.
Department of Gastroenterology, II Clinica Medica, Policlinico Umberto I, University "La Sapienza," Rome, Italy.
E
E
Lahner
P
P
Caruana
G
G
D'Ambra
G
G
Ferraro
E
E
Di Giulio
G
G
Delle Fave
C
C
Bordi
B
B
Annibale
D000328:Adult; D000368:Aged; D000752:Anemia, Pernicious / Q000175:diagnosis; D001706:Biopsy; D002276:Carcinoid Tumor / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D019861:Enterochromaffin-like Cells; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa; D005755:Gastrins / Q000032:analysis; D005757:Gastritis, Atrophic / Q000150:complications*; D005773:Gastroscopy / Q000379:methods*; D016481:Helicobacter Infections / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000032:analysis; D011127:Polyps / Q000175:diagnosis; D011446:Prospective Studies; D011706:Pyloric Antrum; D011897:Random Allocation; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D013997:Time Factors
D005755:Gastrins; D020116:Pepsinogen A