Long-term follow-up in atrophic body gastritis patients: atrophy and intestinal metaplasia are persistent lesions irrespective of Helicobacter pylori infection.
BACKGROUND
Long-term outcome of atrophic body gastritis has not yet been defined.


OBJECTIVE
To investigate at long-term follow-up the behaviour of atrophy and intestinal metaplasia and the occurrence of neoplastic lesions in atrophic body gastritis patients.


METHODS
Overall 106 atrophic body gastritis patients with > or = 4-year follow-up were studied; 38 were Helicobacter pylori-positive at histology + serology and cured of infection (group A), 36 were positive at serology and not treated (group B) and 32 were H. pylori-negative (group C). Patients underwent gastroscopy with antral (n = 3) and body (n = 3) biopsies for histology according to the Sydney System.


RESULTS
At 6.7-year follow-up body atrophy and intestinal metaplasia remained unchanged in all 106 patients irrespective of H. pylori status. Antral atrophy was significantly increased at follow-up only in group C, whereas antral intestinal metaplasia was unchanged in all three groups. During follow-up eight (8%) patients developed neoplastic lesions (one adenocarcinoma, one adenoma with low-grade dysplasia and six low-grade dysplasia without endoscopic lesions). Antral atrophic gastritis was present at baseline in all but one (88%) of the eight patients with neoplastic lesions, but only in 15 (15%) of the 98 patients without (P < 0.0001, RR = 26.7).


CONCLUSIONS
Atrophy and intestinal metaplasia persist at 6.7-year follow-up and atrophic body gastritis patients with panatrophic gastritis are at increased risk of developing neoplastic lesions.
Lahner
E
E
Digestive and Liver Disease Unit, 2nd Medical School, University La Sapienza, Rome, Italy.
Bordi
C
C
Cattaruzza
M S
MS
Iannoni
C
C
Milione
M
M
Delle Fave
G
G
Annibale
B
B
D000328:Adult; D000368:Aged; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D005757:Gastritis, Atrophic / Q000209:etiology*; D016481:Helicobacter Infections; D016480:Helicobacter pylori; D006801:Humans; D007414:Intestinal Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies