Occurrence of gastric cancer and carcinoids in atrophic gastritis during prospective long-term follow up

• Published in: Scandinavian journal of gastroenterology 2015-07, Vol.50 (7), p.856-865
• Main Authors: Lahner, Edith, Esposito, Gianluca, Pilozzi, Emanuela, Purchiaroni, Flaminia, Corleto, Vito D, Di Giulio, Emilio, Annibale, Bruno
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; atrophic gastritis; Biopsy; Carcinoid Tumor - pathology; Cohort Studies; Female; follow up; gastric cancer; Gastritis, Atrophic - pathology; Gastroscopy; Helicobacter pylori - pathogenicity; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Multivariate Analysis; Neoplasm Staging; pernicious anemia; Regression Analysis; Risk Factors; Stomach Neoplasms - pathology; type I gastric carcinoids; Young Adult
• ISSN: 0036-5521; 1502-7708
• DOI: 10.3109/00365521.2015.1010570

AbstractObjective. Atrophic gastritis (AG) is a risk condition for gastric cancer and type I gastric carcinoids. Recent studies assessing the overall risk of gastric cancer and carcinoids in AG at long-term follow up are lacking. This study aimed to investigate in a prospective cohort of AG patients the occurrence of gastric cancer and carcinoids at long-term follow up. Methods. A total of 200 AG patients from a prospective cohort (67% female, median age 55 years) with a follow up of 7.5 (range: 4-23.4) years were included. Inclusion criteria were presence of AG and at least one follow-up gastroscopy with biopsies at ≥4 years after AG diagnosis. Follow-up gastroscopies at 4-year intervals were performed. Results. Overall, 22 gastric neoplastic lesions were detected (crude incidence 11%). Gastric cancer was diagnosed in four patients at a median follow up of 7.2 years (crude incidence 2%). Eleven type I gastric carcinoids were detected at a median follow up of 5.1 years (crude incidence of 5.5%). In seven patients, six low-grade and one high-grade dysplasia were found. The annual incidence rate person-year were 0.25% (95% confidence interval [CI]: 0.067-0.63%), 0.43% (95% CI: 0.17-0.89%), and 0.68% (95% CI: 0.34-1.21%) for gastric cancer, dysplasia, and type I-gastric carcinoids, respectively. The incidence rates of gastric cancer and carcinoids were not different (p = 0.07). Conclusion. This study shows an annual incidence rate of 1.36% person-year for gastric neoplastic lesions in AG patients at long-term follow up. AG patients are similarly exposed to gastric cancer and type I gastric carcinoids.