title: Prevalence of gastric precancerous lesions in Ardabil, a high incidence province for gastric adenocarcinoma in the northwest of Iran.
abstract: OBJECTIVE
  Ardabil Province, in northwestern Iran, has the highest rate of gastric (predominantly cardia) adenocarcinoma in Iran. This study aimed to investigate the feasibility of endoscopic screening and to look for associated Helicobacter pylori infection and gastric precancerous lesions.
  
  
  METHODS
  One thousand one hundred and five adult volunteers, residents of Ardabil and Meshkinshahr, districts, 40 years old and above were selected and invited by a simple random household canvass in rural and urban locations. Informed consents were obtained and upper gastrointestinal video endoscopy was performed to biopsy all visible lesions and standard sites in the antrum, corpus, and cardia.
  
  
  RESULTS
  One thousand and eleven of the invited individuals agreed to participate, including 494 men and 517 women, with a mean (SD) age of 53.32 (10.39) years. Endoscopy was well tolerated by all subjects; 96.7% of antral and 80.7% of cardia mucosal biopsies were satisfactory. The urease test or histology for H pylori was positive in at least 89.2% of subjects. Histological evidence of mucosal atrophy was seen in 39.3% of antral and 21.9% of cardia samples. Chronic gastritis with or without activity, reactive atypia of glandular epithelium, intestinal metaplasia, dysplasia, and cancer were found in 95.1%, 38.0%, 8.7%, 0.2%, and 0.3% of antral and 85.3%, 22.9%, 3.8%, 0.3%, and 0.1% of cardiac biopsies, respectively.
  
  
  CONCLUSIONS
  Endoscopic screening for upper gastrointestinal diseases was feasible and well tolerated in Ardabil, Iran. Most subjects showed H pylori infection. Atrophic gastritis, reactive atypia, and intestinal metaplasia were common in antrum, corpus, and cardia subsites.
authors.affiliation: Digestive Disease Research Centre, Tehran University of Medical Science, Tehran, 14114, Iran. malek@ams.ac.ir
authors.forename: R
authors.initials: R
authors.lastname: Malekzadeh
authors.forename: M
authors.initials: M
authors.lastname: Sotoudeh
authors.forename: M H
authors.initials: MH
authors.lastname: Derakhshan
authors.forename: J
authors.initials: J
authors.lastname: Mikaeli
authors.forename: A
authors.initials: A
authors.lastname: Yazdanbod
authors.forename: S
authors.initials: S
authors.lastname: Merat
authors.forename: A
authors.initials: A
authors.lastname: Yoonessi
authors.forename: M
authors.initials: M
authors.lastname: Tavangar
authors.forename: B Ardakani
authors.initials: BA
authors.lastname: Abedi
authors.forename: R
authors.initials: R
authors.lastname: Sotoudehmanesh
authors.forename: A
authors.initials: A
authors.lastname: Pourshams
authors.forename: A Ali
authors.initials: AA
authors.lastname: Asgari
authors.forename: S
authors.initials: S
authors.lastname: Doulatshahi
authors.forename: B Ziad
authors.initials: BZ
authors.lastname: Alizadeh
authors.forename: S
authors.initials: S
authors.lastname: Arshi
authors.forename: A
authors.initials: A
authors.lastname: Madjidpoor
authors.forename: S
authors.initials: S
authors.lastname: Mir Moomen
authors.forename: D E
authors.initials: DE
authors.lastname: Fleischer
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004032:Diet / Q000706:statistics & numerical data; D016099:Endoscopy, Gastrointestinal; D005240:Feasibility Studies; D005260:Female; D005756:Gastritis / Q000175:diagnosis / Q000453:epidemiology; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology*