title: Analysis of alarming signals for the progression of atrophic gastritis to dysplasia.
abstract: OBJECTIVE
  atrophic gastritis (AG) and dysplasia are precancerous lesions, with which early surveillance of disease progression is particularly important for patients. The present study aimed to explore potential alarming signals for atrophic gastritis progression towards dysplasia.
  
  
  METHODS
  clinical data for patients with AG in the Digestive Endoscopy Center of Guangzhou Nanfang Hospital between 2001 and 2011 were retrospectively reviewed. Survival analysis, dichotomous logistic regression analysis and rank correlation analysis were carried out.
  
  
  RESULTS
  in 234 patients with atrophic gastritis, after follow up of 0.5, 1, 2, 5 and 10 years, the occurrence rates of dysplasia were respectively 2.3, 4.4, 9.6, 19.3, and 42.4%. Patients with AG combined with antral ulcer or gastric angle ulcer, had a higher risk for dysplasia than patients with simple AG (OR = 2.427, 95%Cl 1.069 ~ 5.511, p = 0.034; OR = 2.961, 95%Cl 1.336 ~ 6.564, p = 0.008). The constituent ratios of moderate to severe dysplasia were respectively 8.6, 2.7 and 1.2% (p = 0.000) in three patient groups: AG combined with antral ulcer/gastric angle ulcer (n = 255), antral ulcer/gastric angle ulcer alone (n = 1,389), and AG alone (n = 3,106). The Spearman correlation coefficients between a) Hp infection; and b) atrophy, intestinal metaplasia and dysplasia were -0.114 (p = 0.078), -0.169 (p = 0.009) and 0.064 (p > 0.05), respectively.
  
  
  CONCLUSIONS
  long follow-up interval and gastric ulcer may be alarming signals for the progression of AG to dysplasia. But in patients with atrophy, intestinal metaplasia or dysplasia, Hp infection may not be a risk factor for these lesions aggravated, further studies are required to confirm it.
authors.affiliation: Department of Gastroenterology, Nanfang Hospita, Guangzhou, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhang
authors.forename: Zhouyang
authors.initials: Z
authors.lastname: Lian
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Yadong
authors.initials: Y
authors.lastname: Wang
authors.forename: Fachao
authors.initials: F
authors.lastname: Zhi
authors.forename: Shengli
authors.initials: S
authors.lastname: An
authors.forename: Bo
authors.initials: B
authors.lastname: Jiang
authors.forename: Yali
authors.initials: Y
authors.lastname: Zhang
authors.forename: Yang
authors.initials: Y
authors.lastname: Bai
mesh_terms: D001284:Atrophy; D016208:Databases, Factual; D018450:Disease Progression; D004724:Endoscopy; D005260:Female; D005757:Gastritis, Atrophic / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013276:Stomach Ulcer / Q000209:etiology; D016019:Survival Analysis; D016896:Treatment Outcome