title: Gastric cancer risk according to the distribution of intestinal metaplasia and neutrophil infiltration.
abstract: OBJECTIVE
  Gastritis and intestinal metaplasia (IM) have long been known to be risk factors for and precursors of gastric cancer. We aimed to elucidate the association between gastric cancer risk and the distribution of precancerous lesions in the stomach by histological analyses.
  
  
  METHODS
  We analyzed patients from whom two biopsy specimens (one from the antrum and one from the corpus) were obtained by upper gastrointestinal endoscopy. Specimens were assessed for Helicobacter pylori, IM, and neutrophil infiltration (NI). Patients were classified into three groups based on the presence of IM. Patients were also classified into four groups based on the presence of NI. The prevalence of gastric cancer was compared between groups.
  
  
  RESULTS
  A total of 1395 patients were analyzed. Of these, 54 had gastric cancer (34 intestinal and 20 diffuse type). A multivariate analysis showed that male sex and the distribution of IM were independent risk factors for intestinal-type cancer. Compared with patients without IM (n = 1005), the odds ratio (OR) for patients with IM in the antrum only (n = 240) was 2.34 (95% confidence interval: 1.08-4.96), and that for patients with IM in the corpus (n = 150) was 5.84 (2.92-11.8). However, NI was related to diffuse-type cancer. Compared with patients without NI (n = 899), the OR for patients with NI in the corpus only (n = 122) was 3.66 (1.02-12.2).
  
  
  CONCLUSIONS
  The histological pattern and distribution of gastric mucosal change assessed by two biopsy specimens were related to gastric cancer.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Sakitani
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hirata
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Watabe
authors.forename: Atsuo
authors.initials: A
authors.lastname: Yamada
authors.forename: Takafumi
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamaji
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Yoshida
authors.forename: Shin
authors.initials: S
authors.lastname: Maeda
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D016009:Chi-Square Distribution; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D005773:Gastroscopy; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D015999:Multivariate Analysis; D020556:Neutrophil Infiltration; D016017:Odds Ratio; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology