title: Distribution of intestinal metaplasia as a predictor of gastric cancer development.
abstract: OBJECTIVE
  Helicobacter pylori, gastritis, and intestinal metaplasia (IM) are known risk factors for gastric cancer. In the present study, we conducted a cohort study to evaluate the predictive value of the distribution of IM for gastric cancer development.
  
  
  METHODS
  We conducted a retrospective cohort study at a university hospital. From June 1998 to December 2000, we assessed histological gastritis using biopsy specimens, one from the antrum and one from the corpus, from 1450 patients, among whom 729 revisited for follow-up endoscopy. Patients were classified into three groups according to the distribution of IM at initial endoscopy. IM group A had no IM, IM group B had IM in the antrum only, and IM group C had IM in the corpus. The development of gastric cancer was assessed by endoscopic examination.
  
  
  RESULTS
  The mean duration of follow-up was 6.7 ± 4.7 years. The cumulative incidence of gastric cancer at 5 years was 1.5% in total and 0.8%, 3.3%, and 2.7% in IM groups A, B, and C, respectively. The IM group was identified as an independent risk factor by multivariate analysis; compared with IM group A, hazard ratios were 3.6 (95% confidence interval [CI] 1.1-12.1) in IM group B and 3.8 (95% CI 1.01-14.1) in IM group C. In IM group C, the incidence of gastric cancer in patients who received eradication therapy was significantly lower than that in patients who did not receive (P = 0.021, log-rank).
  
  
  CONCLUSIONS
  IM is a good predictive marker for the development of gastric cancer.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Satoki
authors.initials: S
authors.lastname: Shichijo
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hirata
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Sakitani
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Shinzo
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Serizawa
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Niikura
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Watabe
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Yamada
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamaji
authors.affiliation: Department of Pathology, The University of Tokyo, Tokyo, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ushiku
authors.affiliation: Department of Pathology, The University of Tokyo, Tokyo, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukayama
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005756:Gastritis / Q000150:complications* / Q000382:microbiology*; D005757:Gastritis, Atrophic / Q000209:etiology; D005773:Gastroscopy; D016481:Helicobacter Infections; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D007422:Intestines / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000209:etiology; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000209:etiology*
keywords: Helicobacter pylori; gastric cancer; intestinal metaplasia