title: The corpus-predominant gastritis index may serve as an early marker of Helicobacter pylori-infected patients at risk of gastric cancer.
abstract: BACKGROUND
  To eradicate Helicobacter pylori before the occurrence of precancerous changes is important to prevent gastric carcinogenesis.
  
  
  OBJECTIVE
  To validate whether the corpus-predominant gastritis index (CGI) can serve as an early marker to identify the H. pylori-infected patients at risk of gastric carcinogenesis.
  
  
  METHODS
  This study enrolled 188 subjects, including 43 noncardiac gastric cancer patients, 63 of their first-degree relatives and 82 sex- and age-matched duodenal ulcer patients as controls. All received endoscopy to provide topographic gastric specimens to test for H. pylori infection and its related histological features, translated into the operative link on gastritis assessment (OLGA), operative link on gastric intestinal metaplasia assessment (OLGIM) stages, and the presence of CGI. Spasmolytic polypeptide-expressing metaplasia (SPEM) was assessed by immunohistochemistry staining of trefoil factor 2.
  
  
  RESULTS
  Gastric cancer patients had higher prevalence of CGI and OLGIM stage II-IV, but not OLGA stage II-IV, than the controls (P = 0.001, OR = 3.4[95% CI: 1.4-8.1] for CGI; OR = 5.0[95% CI: 2.0-12.8] for OLGIM). In patients with the combined presence of CGI and OLGIM stage II-IV, the risk of gastric cancer increased to 9.8 (P < 0.001). The first-degree relatives of the gastric cancer patients had a higher rate of the presence of CGI, but not OLGA or OLGIM stage II-IV than the duodenal ulcer controls (P = 0.001). Of the first-degree relatives, the presence of CGI increased the risk of SPEM (P = 0.003, OR = 5.5[95% CI: 1.8-17.0]).
  
  
  CONCLUSIONS
  The corpus-predominant gastritis index, which is highly correlated to SPEM, may serve as an early marker to identify the H. pylori-infected patients at a higher risk of gastric cancer.
authors.affiliation: Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Y-C
authors.initials: YC
authors.lastname: Tsai
authors.forename: W-H
authors.initials: WH
authors.lastname: Hsiao
authors.forename: H-B
authors.initials: HB
authors.lastname: Yang
authors.forename: H-C
authors.initials: HC
authors.lastname: Cheng
authors.forename: W-L
authors.initials: WL
authors.lastname: Chang
authors.forename: C-C
authors.initials: CC
authors.lastname: Lu
authors.forename: B-S
authors.initials: BS
authors.lastname: Sheu
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000382:microbiology; D000328:Adult; D015415:Biomarkers; D016022:Case-Control Studies; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005756:Gastritis / Q000378:metabolism / Q000473:pathology*; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D010375:Pedigree; D010455:Peptides / Q000378:metabolism; D012307:Risk Factors; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000382:microbiology; D000071164:Trefoil Factor-2
chemical_list: D015415:Biomarkers; D010455:Peptides; C000604007:TFF2 protein, human; D000071164:Trefoil Factor-2