title: Chronic atrophic gastritis is a progressive disease: analysis of medical reports from Shanghai (1985-2009).
abstract: BACKGROUND
  We aimed to examine the turnover of chronic atrophic gastritis (CAG) pathologically and endoscopically and explore its potential causes.
  
  
  METHODS
  A retrospective analysis was conducted of prospective data collected from 1,592 patients who underwent gastroscopy three times or more during the period 1985-2009 at Renji Hospital, Shanghai, China. Pathological and endoscopic findings were analysed. Data collected included gender, age, length of follow-up period, family history, past medical history, history of Helicobacter (H.) pylori infection, drug history for the use of proton pump inhibitors (PPIs), antacids and non-steroidal anti-inflammatory drugs [NSAIDs], and lifestyle history, including the patients' eating habits.
  
  
  RESULTS
  23 (1.44%) patients presented with gastric cancers resulting from CAG and 349 (21.92%) patients had dysplasia. Pathological and endoscopic findings suggested that the proportion of patients with worsening gastric mucosa during the atrophic and intestinal metaplasia (IM) phases was over 35% with increasing age. Gastric mucosa was found to be pathologically aggravated by carbonated drinks and fast food, and pathologically degenerated by H. pylori infection. Smoking deteriorated the gastric mucosa. Side dishes of vegetables may benefit the gastric mucosa even in the atrophic and IM phases.
  
  
  CONCLUSIONS
  Our findings support the consensus that CAG is a progressive disease. Potential factors that were found to affect the state of the gastric mucosa in our patient group were gender, H. pylori infection, use of PPIs or NSAIDs, and intake of vegetable side dishes, spicy food, carbonated drinks and fast food.
authors.affiliation: Division of Gastroenterology and Hepatology, Shanghai Jiao-Tong University School of Medicine, Renji Hospital, Shanghai 200001, China.
authors.forename: Eugene Yuo Hao
authors.initials: EY
authors.lastname: Chooi
authors.forename: Hui-Min
authors.initials: HM
authors.lastname: Chen
authors.forename: Qi
authors.initials: Q
authors.lastname: Miao
authors.forename: Yu-Rong
authors.initials: YR
authors.lastname: Weng
authors.forename: Xiao-Yu
authors.initials: XY
authors.lastname: Chen
authors.forename: Zhi-Zheng
authors.initials: ZZ
authors.lastname: Ge
authors.forename: Shu-Dong
authors.initials: SD
authors.lastname: Xiao
authors.forename: Jing-Yuan
authors.initials: JY
authors.lastname: Fang
mesh_terms: D000328:Adult; D017677:Age Distribution; D001706:Biopsy; D002681:China / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology*; D005757:Gastritis, Atrophic / Q000175:diagnosis / Q000453:epidemiology*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors