Type III intestinal metaplasia, Helicobacter pylori infection and gastric carcinoma risk index in an Italian series of 1750 patients.
OBJECTIVE
To evaluate the utility of 2 biopsies of antrum and gastric body on routine endoscopy for the assessment of type III intestinal metaplasia (IM-3) and Helicobacter pylori (Hp), 1750 patients (pts) (895 males; 855 females) were considered from June'98 to June'00.


METHODS
Specimens were graded 0 to 3 for atrophy, IM-3 and Hp. 610 pts treated previously with antibiotics or not eligible for biopsy were excluded from initial 2360 pts.


RESULTS
IM-3 was found in 118 pts (6.7%), 100 pts (5.7%) only in the antrum. 10 of 355 pts (2.8%) with normal endoscopy and 47 of 702 (6.6%) with non-erosive endoscopic gastritis resulted IM-3 positive in the antrum. 709 pts (40.5%) were positive for Hp in antrum and/or 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. The gastric carcinoma risk index (GCRI) was found in 358 pts (20.4%); in this group 131 pts (36.6%) were Hp positive, 81 pts (22.65%) had IM-3 only in the antrum, 184 pts (51.4%) had atrophy.


CONCLUSIONS
The incidence of IM-3 is low (6.7%) in routine endoscopy. Normal endoscopy doesn't exclude the presence of IM-3. 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 for identifying a group of patients carrying a higher risk for gastric carcinoma.
Suriani
Renzo
R
Department of Gastroenterology, Ospedale Nuovo, Rivoli, Italy.
Venturini
Ivo
I
Taraglio
Stefano
S
Mazzucco
Dario
D
Grosso
Silvia
S
Predebon
Stefania
S
Mamo
Carlo
C
Tremosini
Silvia
S
Ballesini
Pietro
P
Borghi
Athos
A
Zeneroli
Maria Luisa
ML
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005757:Gastritis, Atrophic / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D007422:Intestines / Q000473:pathology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008679:Metaplasia / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000209:etiology*