title: Preventive effects of etodolac, a selective cyclooxygenase-2 inhibitor, on cancer development in extensive metaplastic gastritis, a Helicobacter pylori-negative precancerous lesion.
abstract: The present study investigated the preventive effects of etodolac, a selective cyclo-oxygenase (COX)-2 inhibitor, on metachronous cancer development after endoscopic resection of early gastric cancer. Among 267 early gastric cancer patients who underwent endoscopic resection, 47 patients with extensive metaplastic gastritis were selected based on endoscopic findings and our previously described criteria of serum pepsinogen (PG) test-positive and Helicobacter pylori antibody-negative conditions. Nonrandomized etodolac treatment (300 mg/day) was administered to 26 patients (Group A), while the remaining 21 patients were untreated (Group B). No significant differences in age, sex distribution, lifestyle factors or extent of metaplastic gastritis at baseline were identified between groups. Patients were followed for metachronous cancer development with endoscopy every 6-12 months for up to 5 years. Mean (standard deviation) follow-up period was 4.2 (0.9) years. In Group B, 5 cancers developed (incidence rate = 6,266/100,000 person-years), significantly more than the 1 cancer in Group A (incidence rate = 898/100,000 person-years; p < 0.05). Long-term etodolac treatment did not influence the extent of metaplastic gastritis as revealed by endoscopic findings or by serum PG levels, but effectively reduced metachronous cancer development in patients with extensive metaplastic gastritis. These results strongly suggest that chemoprevention of cancer in the metaplastic stomach is possible by controlling COX-2 expression.
authors.affiliation: Department of Gastroenterology, School of Medicine, Wakayama Medical University, Wakayama City, Wakayama 641-0012, Japan.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Yanaoka
authors.forename: Masashi
authors.initials: M
authors.lastname: Oka
authors.forename: Noriko
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Deguchi
authors.forename: Chizu
authors.initials: C
authors.lastname: Mukoubayashi
authors.forename: Shotaro
authors.initials: S
authors.lastname: Enomoto
authors.forename: Takao
authors.initials: T
authors.lastname: Maekita
authors.forename: Izumi
authors.initials: I
authors.lastname: Inoue
authors.forename: Kazuki
authors.initials: K
authors.lastname: Ueda
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Utsunomiya
authors.forename: Mikitaka
authors.initials: M
authors.lastname: Iguchi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Tamai
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fujishiro
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Inada
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Takeshita
authors.forename: Masao
authors.initials: M
authors.lastname: Ichinose
mesh_terms: D000368:Aged; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D017308:Etodolac / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005756:Gastritis / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000150:complications / Q000382:microbiology / Q000517:prevention & control; D013270:Stomach / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D013274:Stomach Neoplasms / Q000150:complications / Q000517:prevention & control* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D017308:Etodolac