title: Risk factors for progression to gastric neoplastic lesions in patients with atrophic gastritis.
abstract: BACKGROUND
  Atrophic gastritis, involving the gastric body mucosa, predisposes to gastric neoplastic lesions (GNL). However, regular gastroscopic-histological follow-up for GNL is not recommended for patients with atrophic gastritis.
  
  
  OBJECTIVE
  To evaluate risk factors for the progression to GNL in a cohort of patients with atrophic gastritis.
  
  
  METHODS
  A total of 300 patients with atrophic gastritis [205 women, aged 54 (18-78) years] underwent gastroscopy with six gastric antrum and body biopsies. All patients had at least one follow-up gastroscopy/histology at an interval of at least 1 year after the atrophic gastritis diagnosis. Baseline clinical and histological features were analysed as risk factors for the development of GNL by Cox-regression.
  
  
  RESULTS
  During a median follow-up of 4.3 (1-16.5) years, 15 GNL were detected in 14 of the 300 patients with atrophic gastritis: three were gastric cancer, whereas 12 were non-invasive neoplasia. The annual incidence for GNL was 1%. Cox-regression analysis identified the following risk factors: age over 50 years (HR 8.8, 95%CI 1.2-68.4), atrophic pangastritis (HR 4.5, 95% CI 1.5-14.1) and severe intestinal metaplasia in the gastric body (HR 4.0, 95% CI 1.3-11.8).
  
  
  CONCLUSIONS
  Atrophic pangastritis, severe body intestinal metaplasia and/or age over 50 years increase the risk for developing GNL in patients with atrophic gastritis. In this subset of patients, an endoscopic-histological follow-up for GNL surveillance may be worthwhile.
authors.affiliation: Department of Digestive and Liver Disease, Sant'Andrea Hospital, II School of Medicine, University Sapienza of Rome, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Vannella
authors.forename: E
authors.initials: E
authors.lastname: Lahner
authors.forename: J
authors.initials: J
authors.lastname: Osborn
authors.forename: C
authors.initials: C
authors.lastname: Bordi
authors.forename: M
authors.initials: M
authors.lastname: Miglione
authors.forename: G
authors.initials: G
authors.lastname: Delle Fave
authors.forename: B
authors.initials: B
authors.lastname: Annibale
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D004812:Epidemiologic Methods; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005757:Gastritis, Atrophic / Q000473:pathology*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology*; D055815:Young Adult