title: Precancerous gastric conditions in high Helicobacter pylori prevalence areas: comparison between Eastern European (Lithuanian, Latvian) and Asian (Taiwanese) patients.
abstract: The aim of the study was to compare the prevalence and severity of precancerous condition--gastric atrophy and intestinal metaplasia (IM) between Eastern European (Lithuania and Latvia) and Asian (Taiwan) countries in population older than 55 years.
  
  
  METHODS
  Patients aged 55 years and older, referred for upper endoscopy due to dyspeptic symptoms, were included in the study. Gastric biopsies were histological investigated according modified Sydney classification. Helicobacter pylori (H. pylori) was detected if any two of three methods (urease test, histology, and serology) were positive.
  
  
  RESULTS
  Overall 322 patients included: 52 from Taiwan (TW), 171 from Latvia (LV) and 99 from Lithuania (LT). There were 227 (70%) females and 95 (30%) males. The mean age of TW patients was significantly lower (61.0+/-5.8 years), than of LV (68.1+/-7.3 years) and LT (66.5+/-7.5 years) patients. H. pylori was established in 224 (69.6%) patients. H. pylori positivity was established in 43 (82.7%) TW patients, in 112 (65.5%) LV patients, and in 69 (69.7%) LT patients (P>0.05). In H. pylori-infected patients, any atrophy either in the corpus or in the antrum of the stomach was detected in 26 (60.5%) TW patients, in 40 (35.7%) LV patients, and in 36 (52.2%) LT patients (between TW and LV patients P<0.005). Severe atrophy (grade 2 or 3) detected in 8 (18.6%) TW patients, in 17 (15.2%) LV patients, and in 18 (26.1%) LT patients (P>0.05). Intestinal metaplasia was detected in 22 (51.2%) TW patients, in 37 (33.0%) LV patients and in 31 (44.9%) LT patients among countries (P>0.05). There were no significant differences in proportions of different degrees of both atrophy and intestinal metaplasia among countries. Intestinal metaplasia was found in 79 (77.5%) of 102 patients with any degree of atrophy and in 11 (9.0%) of 122 patients without atrophy (P<0.0001). We found strong statistically significant correlations between atrophy and intestinal metaplasia in antrum (r=0.89), P<0.01, and corpus (r= 0.73), P<0.01.
  
  
  CONCLUSIONS
  The prevalence of H. pylori in the elderly population is still high in LT, LV, and TW. There are no significant differences in prevalence of gastric atrophy and intestinal metaplasia among TW, LT, and LV. There is a strong correlation between gastric atrophy and intestinal metaplasia.
authors: Department of Gastroenterology, Kaunas University of Medicine, Kaunas, Lithuania. laimasj@takas.lt
authors: Laimas
authors: L
authors: Jonaitis
authors: Audrius
authors: A
authors: Ivanauskas
authors: Dainius
authors: D
authors: Janciauskas
authors: Konrads
authors: K
authors: Funka
authors: Agnese
authors: A
authors: Sudraba
authors: Ivars
authors: I
authors: Tolmanis
authors: Alvils
authors: A
authors: Krams
authors: Dans
authors: D
authors: Stirna
authors: Aigars
authors: A
authors: Vanags
authors: Limas
authors: L
authors: Kupcinskas
authors: Marcis
authors: M
authors: Leja
authors: Jaw-Town
authors: JT
authors: Lin
mesh_terms: D000368:Aged; D001284:Atrophy; D001706:Biopsy; D005260:Female; D005757:Gastritis, Atrophic / Q000175:diagnosis / Q000453:epidemiology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D007844:Latvia; D008097:Lithuania; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000473:pathology; D013624:Taiwan