title: Risk factors associated with gastric cancer in patients with a duodenal ulcer.
abstract: BACKGROUND
  Although gastric cancer (GC) and duodenal ulcer (DU) are both strongly associated with Helicobacter pylori infection, a DU is negatively associated with the risk of GC. The aim of the study is to evaluate histologic risk factors for GC among patients with a DU.
  
  
  METHODS
  A total of 541 consecutive patients with GC were prospectively evaluated for the presence of a DU. Control patients with only a DU (n = 89) were recruited from health screening population. Histologic grading was assessed using the updated Sydney system for six gastric biopsies from three regions. GC risk among patients with a DU was evaluated using logistic regression analysis.
  
  
  RESULTS
  Among patients with GC, 7.6% (41/541) had a concomitant DU or an ulcer scar. Corpus-predominant/pangastritis were more frequently found in concomitant GC patients with a DU (90%) than in patients with a DU alone (62%) (p = .001). In patients with a DU, moderate-severe chronic inflammation at the lesser and greater curvatures of corpus was associated with GC risk (OR, 3.70; 95% CI, 1.46-9.36, and OR, 7.72; 95% CI, 3.18-18.7, respectively). Additionally, moderate-severe intestinal metaplasia (IM) at the antrum and corpus lesser curvature was associated with GC risk (OR, 7.52; 95% CI, 3.06-18.5, and OR, 9.25, 95% CI, 2.39-35.8, respectively).
  
  
  CONCLUSIONS
  A DU is not rare in patients with GC in a high-risk region of GC. Patients with a DU with chronic corpus gastritis and IM have an increased risk of GC, thus those patients should be followed up for GC development.
authors.affiliation: Center for Gastric Cancer Center for Cancer Prevention and Detection, National Cancer Center, Gyeonggi, Korea.
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Cho
authors.forename: Il Ju
authors.initials: IJ
authors.lastname: Choi
authors.forename: Chan Gyoo
authors.initials: CG
authors.lastname: Kim
authors.forename: Myeong-Cherl
authors.initials: MC
authors.lastname: Kook
authors.forename: Jong Yeul
authors.initials: JY
authors.lastname: Lee
authors.forename: Byung Chang
authors.initials: BC
authors.lastname: Kim
authors.forename: Kum Hei
authors.initials: KH
authors.lastname: Ryu
authors.forename: Su Youn
authors.initials: SY
authors.lastname: Nam
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004381:Duodenal Ulcer / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology