title: Long-term follow-up in atrophic body gastritis patients: atrophy and intestinal metaplasia are persistent lesions irrespective of Helicobacter pylori infection.
abstract: 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.
authors.affiliation: Digestive and Liver Disease Unit, 2nd Medical School, University La Sapienza, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Lahner
authors.forename: C
authors.initials: C
authors.lastname: Bordi
authors.forename: M S
authors.initials: MS
authors.lastname: Cattaruzza
authors.forename: C
authors.initials: C
authors.lastname: Iannoni
authors.forename: M
authors.initials: M
authors.lastname: Milione
authors.forename: G
authors.initials: G
authors.lastname: Delle Fave
authors.forename: B
authors.initials: B
authors.lastname: Annibale
mesh_terms: 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