title: Outcome of intestinal metaplasia in gastric biopsy of patients with dyspepsia in Guilan Province, North Iran.
abstract: BACKGROUND
  It is generally accepted that gastric carcinomas are preceded by a sequential multistage process that includes chronic gastritis, gastric atrophy, usually with intestinal metaplasia (IM), and dysplasia. This series of changes in gastric carcinogenesis is often initiated by Helicobacter pylori (H pylori) infection. The aim of the present study was determination of gastric histopathologic changes in IM patients after at least one year in Guilan province, Iran.
  
  
  METHODS
  This case-series study was conducted in Guilan Gastrointestinal and Liver Disease Research Center (GLDRC) during 2010 to 2011. Gastric biopsy was performed for all 71 known cases of IM and precanceric lesions including gastric atrophy, IM, dysplasia and H pylori infection were determined after at least one year.
  
  
  RESULTS
  Of the total of 71 patients with established IM who were enrolled, 50 had complete-type IM and 21 had incomplete-type IM. Fifty two people had H pylori infection. H pylori eradication was achieved in 39 patients (75%). Secondary pathology findings of patients with IM were complete metaplasia (39.4%), incomplete metaplasia (32.4%), dysplasia (23.9%) and other precanceric lesions (4.2%). Dysplasia (20%vs 33%) occurred in patients who had complete and incomplete IM at baseline respectively (p>0.05). Age, gender, family history of gastric cancer(GC); smoking habits and NSAIDs use were not associated with gastric premalignant lesions in initial and secondary pathologies (p>0.05). The difference became statistically significant between H pylori infection in patients with more than 3 years diagnostic intervals (p<0.05). Statistical difference between eradicators and non-eradicators was not significant.
  
  
  CONCLUSIONS
  We found that incomplete IM increased the risk of subsequent dysplasia in this study.
authors.affiliation: Division of Gastroenterology and Hepatology, Guilan University of Medical Sciences, Rasht, Iran. ghanaei@gums.ac.ir
authors.forename: Fariborz
authors.initials: F
authors.lastname: Mansour-Ghanaei
authors.forename: Farahnaz
authors.initials: F
authors.lastname: Joukar
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Soati
authors.forename: Alireza
authors.initials: A
authors.lastname: Mansour-Ghanaei
authors.forename: Zahra
authors.initials: Z
authors.lastname: Atrkar-Roushan
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D004415:Dyspepsia / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology*; D005756:Gastritis / Q000209:etiology* / Q000473:pathology; D005757:Gastritis, Atrophic / Q000209:etiology* / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D007492:Iran; D008297:Male; D008679:Metaplasia / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D011230:Precancerous Conditions / Q000209:etiology* / Q000473:pathology; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000209:etiology* / Q000473:pathology; D055815:Young Adult