Prevalence of H pylori associated "high risk gastritis" for development of gastric cancer in patients with normal endoscopic findings.
OBJECTIVE
To investigate the prevalence of H pylori associated corpus-predominant gastritis (CPG) or pangastritis, severe atrophy, and intestinal metaplasia (IM) in patients without any significant abnormal findings during upper-GI endoscopy.


METHODS
Gastric biopsies from 3548 patients were obtained during upper GI-endoscopy in a 4-year period. Two biopsies from antrum and corpus were histologically assessed according to the updated Sydney-System. Eight hundred and forty-five patients (mean age 54.8 +/- 2.8 years) with H pylori infection and no peptic ulcer or abnormal gross findings in the stomach were identified and analyzed according to gastritis phenotypes using different scoring systems.


RESULTS
The prevalence of severe H pylori associated changes like pangastritis, CPG, IM, and severe atrophy increased with age, reaching a level of 20% in patients of the age group over 45 years. No differences in frequencies between genders were observed. The prevalence of IM had the highest increase, being 4-fold higher at the age of 65 years versus in individuals less than 45 years.


CONCLUSIONS
The prevalence of gastritis featuring at risk for cancer development increases with age. These findings reinforce the necessity for the histological assessment, even in subjects with normal endoscopic appearance. The age-dependent increase in prevalence of severe histopathological changes in gastric mucosa, however, does not allow estimating the individual risk for gastric cancer development--only a proper follow-up can provide this information.
Leodolter
Andreas
A
Department of Gastroenterology and Hepatology, Otto-von-Guericke University, Leipziger Street 44, Magdeburg D-39120, Germany. andreas@leodolter.de
Ebert
Matthias P
MP
Peitz
Ulrich
U
Wolle
Kathlen
K
Kahl
Stefan
S
Vieth
Michael
M
Malfertheiner
Peter
P
D000328:Adult; D000367:Age Factors; D000368:Aged; D001284:Atrophy / Q000382:microbiology / Q000473:pathology; D001706:Biopsy; D018450:Disease Progression; D016099:Endoscopy, Gastrointestinal; D005188:False Negative Reactions; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005756:Gastritis / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications* / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000382:microbiology / Q000473:pathology; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology* / Q000473:pathology