title: Relationship between the degree of endoscopic atrophy of the gastric mucosa and carcinogenic risk.
abstract: BACKGROUND
  The relationship between Helicobacter pylori infection and gastric cancer has been demonstrated, and the risk of gastric cancer occurrence is known to increase with the progression of atrophic changes associated with chronic gastritis. Endoscopic evaluation of the degree and extent of atrophy of the gastric mucosa is a simple and very important means of identifying a group at high risk for gastric cancer. This study aimed to clarify the carcinogenic risk in relation to the degree of atrophy.
  
  
  METHODS
  A total of 27,777 patients (272 with early gastric cancer and 135 with advanced gastric cancer) were included in this study. Endoscopically evaluated atrophy of the gastric mucosa was classified as C-0 to O-3 according to the Kimura and Takemoto classification system.
  
  
  RESULTS
  The cancer detection rate in relation to the degree of gastric mucosal atrophy was 0.04% (2/4,183 patients) for C-0, 0% (0/4,506) for C-1, 0.25% (9/3,660) for C-2, 0.71% (21/2,960) for C-3, 1.32% (75/5,684) for O-1, 3.70% (140/3,780) for O-2 and 5.33% (160/3,004) for O-3. As to the proportions of differentiated and undifferentiated cancers, the latter were relatively frequent in the C-0 to C-2 groups, but differentiated cancers became predominant as atrophy progressed. On the other hand, the number of both differentiated and undifferentiated cancers detected increased as gastric mucosal atrophy progressed. In addition, open-type atrophy was found in 29 (96.7%) of 30 patients with synchronous multiple gastric cancers and in all 20 patients with metachronous multiple gastric cancers.
  
  
  CONCLUSIONS
  Endoscopic evaluation of gastric mucosal atrophy can provide a simple and reliable predictive index for both current and future carcinogenic risk.
authors: Masuyama Gastrointestinal Clinic, Otawara, Japan.
authors: Hironori
authors: H
authors: Masuyama
authors: Naoto
authors: N
authors: Yoshitake
authors: Takako
authors: T
authors: Sasai
authors: Tetsuya
authors: T
authors: Nakamura
authors: Atsushi
authors: A
authors: Masuyama
authors: Toru
authors: T
authors: Zuiki
authors: Kentaro
authors: K
authors: Kurashina
authors: Mitsuyo
authors: M
authors: Mieda
authors: Keijiro
authors: K
authors: Sunada
authors: Hironori
authors: H
authors: Yamamoto
authors: Kazutomo
authors: K
authors: Togashi
authors: Akira
authors: A
authors: Terano
authors: Hideyuki
authors: H
authors: Hiraishi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000145:classification* / Q000150:complications / Q000175:diagnosis; D063646:Carcinogenesis / Q000473:pathology*; D055088:Early Detection of Cancer / Q000379:methods; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005757:Gastritis, Atrophic / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012306:Risk; D013274:Stomach Neoplasms / Q000209:etiology* / Q000473:pathology
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