title: Gastric atrophy and xanthelasma are markers for predicting the development of early gastric cancer.
abstract: BACKGROUND
  The significance of gastric xanthelasma in relation to gastric cancer still remains unclear. We investigated whether gastric xanthelasma would be a useful marker for predicting the development of early gastric cancer.
  
  
  METHODS
  A total of 1823 patients who underwent a medical health checkup were enrolled. We examined the relationship between gastric xanthelasma and various clinical features, and in an endoscopic follow-up study investigated whether the presence of gastric xanthelasma was predictive of the development of early gastric cancer.
  
  
  RESULTS
  In the initial endoscopic examination, gastric xanthelasma was detected in 107 (5.9 %) of the 1823 patients. The presence of gastric xanthelasma was significantly associated with age ≥65 years, male gender, open-type atrophy, and the presence of diabetes mellitus (DM) (p < 0.0001, p < 0.0001, p < 0.0001, and p < 0.0001, respectively). During the endoscopic follow-up period, early gastric cancer was found in 29 (1.6 %) of the 1823 patients. Gastric cancer occurred in 15 (14.0 %) of 107 patients with gastric xanthelasma, whereas it occurred in 14 (0.8 %) of 1716 patients without (p < 0.0001). Multivariate analysis revealed that open-type atrophy and gastric xanthelasma were independently related to the development of gastric cancer (odds ratio 7.19 [2.50-20.83]; p = 0.0003 and 5.85 [2.67-12.82]; p < 0.0001, respectively). The presence of gastric xanthelasma was significantly predictive of gastric cancer development even in the selected high-risk groups with open-type atrophy or DM (p < 0.0001 or p < 0.0001, respectively).
  
  
  CONCLUSIONS
  Gastric xanthelasma is a useful marker for predicting the development of gastric cancer.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan. sekky@osaka-med.jrc.or.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Sekikawa
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Fukui
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Sada
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Fukuhara
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Saiko
authors.initials: S
authors.lastname: Marui
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Gensho
authors.initials: G
authors.lastname: Tanke
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Endo
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ohara
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Matsuda
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Henmi
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Sumio
authors.initials: S
authors.lastname: Saito
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Tsumura
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Maruo
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennoji-ku, Osaka, 543-8555, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Osaki
mesh_terms: D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D048909:Diabetes Complications / Q000175:diagnosis; D018450:Disease Progression; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005757:Gastritis, Atrophic / Q000175:diagnosis*; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis*; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000175:diagnosis*; D014973:Xanthomatosis / Q000175:diagnosis*
chemical_list: D001786:Blood Glucose; D008055:Lipids
keywords: Diabetes mellitus; Early gastric cancer; Gastric atrophy; Gastric xanthelasma