Macroscopic extent of gastric mucosal atrophy: increased risk factor for esophageal squamous cell carcinoma in Japan

Tomoyuki Akiyama,Kunihiro Hosono,Yasunobu Abe,Masato Yoneda,Hiroshi Iida,Yasushi Rino,Kensuke Kubota,Masahiko Inamori,Satoru Saito,Hirokazu Takahashi,Ayumu Goto,Atsushi Nakajima,Hiroyuki Kirikoshi,Koji Fujita,Hiroki Endo,Kyoko Yoneda,Noritoshi Kobayashi

doi:10.1186/1471-230x-9-34

Tomoyuki Akiyama, Kunihiro Hosono + Show 15 more

Open Access

https://doi.org/10.1186/1471-230x-9-34

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Journal: BMC gastroenterology	Publication Date: May 18, 2009
Citations: 46	License type: cc-by

Affiliation: Yokohama City University

Abstract

BackgroundWe aimed to estimate whether the macroscopic extent of gastric mucosal atrophy is associated with a risk for esophageal squamous cell carcinoma using a case-control study in Japanese subjects, a population known to have a high prevalence of CagA-positive H. pylori infection.MethodsTwo hundred and fifty-three patients who were diagnosed as having esophageal squamous cell carcinoma, and 253 sex- and age-matched controls were enrolled in the present study. The macroscopic extent of gastric mucosal atrophy was evaluated based on the Kimura and Takemoto Classification. A conditional logistic regression model with adjustment for potential confounding factors was used to assess the associations.ResultsBody gastritis, defined endoscopically, was independently associated with an increased risk for esophageal squamous cell carcinoma.ConclusionOur findings suggest that macroscopic body gastritis may be a risk factor for esophageal squamous cell carcinoma in Japan. Further studies are needed to confirm these findings.

Highlights

We aimed to estimate whether the macroscopic extent of gastric mucosal atrophy is associated with a risk for esophageal squamous cell carcinoma using a case-control study in Japanese subjects, a population known to have a high prevalence of cytotoxin-associated gene A (CagA)-positive H. pylori infection
A large population-based case-control study in Sweden has demonstrated that cytotoxin-associated gene A (CagA)-positive H. pylori infection is an increased risk factor for Esophageal squamous cell carcinoma (ESCC), and gastric mucosal atrophy (GMA) may be an important mediator of the positive association between CagA seropositivity and ESCC [6]. These findings suggest that GMA, induced CagA-positive Helicobacter pylori (H. pylori) infection, is a risk factor for ESCC in Sweden
We investigated whether the macroscopic extent of GMA is associated with a risk for ESCC using a case-control study in Japanese subjects, a population known to have a high prevalence of CagA-positive H. pylori infection

Summary

Introduction

We aimed to estimate whether the macroscopic extent of gastric mucosal atrophy is associated with a risk for esophageal squamous cell carcinoma using a case-control study in Japanese subjects, a population known to have a high prevalence of CagA-positive H. pylori infection. Esophageal cancer is the world's eighth most common malignancy, affecting approximately 500,000 individuals worldwide each year [1]. In Japan, the age-standardized mortality rate of this cancer in 2000 was 10.4/100,000 for men, approximately eight times that of women, and the (page number not for citation purposes). There are two major histological types of esophageal cancer, squamous cell carcinoma and adenocarcinoma, and their epidemiological features differ considerably. The frequency of squamous cell carcinoma in Western countries has declined while there has been a dramatic rise in the frequency of esophageal adenocarcinoma over the past several decades [3,4]. More than 90% of esophageal cancers in Japan have been squamous cell carcinoma, and no significant changes have been identified [5]

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