title: Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia.
abstract: OBJECTIVE
  To determine which clinical factors might be associated with gastric intestinal metaplasia (IM) in a North American population.
  
  
  METHODS
  Pathology and endoscopy databases at an academic medical center were reviewed to identify patients with and without gastric IM on biopsies for a retrospective cohort study. Patient demographics, insurance status, and other clinical factors were reviewed.
  
  
  RESULTS
  Four hundred and sixty-eight patients with gastric IM (mean age: 61.0 years ± 14.4 years, 55.5% female) and 171 without gastric IM (mean age: 48.8 years ± 20.8 years, 55.0% female) were compared. The endoscopic appearance of atrophic gastritis correlated with finding gastric IM on histopathology (OR = 2.05,P= 0.051). Gastric IM was associated with histologic findings of chronic gastritis (OR = 2.56,P< 0.001), gastric ulcer (OR = 6.97,P= 0.015), gastric dysplasia (OR = 6.11,P= 0.038), and gastric cancer (OR = 6.53,P= 0.027). Histologic findings of Barrett's esophagus (OR = 0.28,P= 0.003) and esophageal dysplasia (OR = 0.11,P= 0.014) were inversely associated with gastric IM. Tobacco use (OR = 1.73,P= 0.005) was associated with gastric IM.
  
  
  CONCLUSIONS
  Patients who smoke or have the endoscopic finding of atrophic gastritis are more likely to have gastric IM and should have screening gastric biopsies during esophagogastroduodenoscopy (EGD). Patients with gastric IM are at increased risk for having gastric dysplasia and cancer, and surveillance EGD with gastric biopsies in these patients might be reasonable.
authors.affiliation: Justin M Gomez, Wissam Bleibel, Jeanetta W Frye, Bryan G Sauer, Vanessa M Shami, Andrew Y Wang, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA 22908, United States.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Gomez
authors.affiliation: Justin M Gomez, Wissam Bleibel, Jeanetta W Frye, Bryan G Sauer, Vanessa M Shami, Andrew Y Wang, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA 22908, United States.
authors.forename: James T
authors.initials: JT
authors.lastname: Patrie
authors.affiliation: Justin M Gomez, Wissam Bleibel, Jeanetta W Frye, Bryan G Sauer, Vanessa M Shami, Andrew Y Wang, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA 22908, United States.
authors.forename: Wissam
authors.initials: W
authors.lastname: Bleibel
authors.affiliation: Justin M Gomez, Wissam Bleibel, Jeanetta W Frye, Bryan G Sauer, Vanessa M Shami, Andrew Y Wang, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA 22908, United States.
authors.forename: Jeanetta W
authors.initials: JW
authors.lastname: Frye
authors.affiliation: Justin M Gomez, Wissam Bleibel, Jeanetta W Frye, Bryan G Sauer, Vanessa M Shami, Andrew Y Wang, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA 22908, United States.
authors.forename: Bryan G
authors.initials: BG
authors.lastname: Sauer
authors.affiliation: Justin M Gomez, Wissam Bleibel, Jeanetta W Frye, Bryan G Sauer, Vanessa M Shami, Andrew Y Wang, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA 22908, United States.
authors.forename: Vanessa M
authors.initials: VM
authors.lastname: Shami
authors.affiliation: Justin M Gomez, Wissam Bleibel, Jeanetta W Frye, Bryan G Sauer, Vanessa M Shami, Andrew Y Wang, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA 22908, United States.
authors.forename: Edward B
authors.initials: EB
authors.lastname: Stelow
authors.affiliation: Justin M Gomez, Wissam Bleibel, Jeanetta W Frye, Bryan G Sauer, Vanessa M Shami, Andrew Y Wang, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA 22908, United States.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Moskaluk
authors.affiliation: Justin M Gomez, Wissam Bleibel, Jeanetta W Frye, Bryan G Sauer, Vanessa M Shami, Andrew Y Wang, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, VA 22908, United States.
authors.forename: Andrew Y
authors.initials: AY
authors.lastname: Wang
keywords: Atrophic gastritis; Biopsies; Esophagogastroduodenoscopy; Gastric; Intestinal metaplasia