Incidence Of Gastric Neoplasm Research Articles

Metabolic Factors Associated with Endoscopic Atrophy, Intestinal Metaplasia, and Gastric Neoplasms in Helicobacter pylori-Positive Patients.

Previous studies demonstrate an association between metabolic factors and Helicobacter pylori-related gastric cancer. However, the association of gastric atrophy or intestinal metaplasia (IM) with these factors remains unknown. Data on 1603 Helicobacter pylori-positive patients who underwent esophagogastroduodenoscopy between 2001 and 2021 were evaluated. The outcome measures were endoscopic atrophy, IM grade, and the incidence of endoscopically diagnosed and pathologically confirmed gastric neoplasms. Clinical factors associated with these findings were also determined. Advanced age; successful Helicobacter pylori eradication; and comorbidities including diabetes mellitus (DM), hypertension, dyslipidemia, and fib4 index were significantly associated with endoscopic gastric atrophy grade. Male sex; advanced age; and comorbidities including DM, hypertension, dyslipidemia, hyperuricemia, fatty liver, aortic calcification, and fib4 index were also significantly associated with endoscopic IM grade, whereas advanced age, successful Helicobacter pylori eradication, DM, fatty liver, and fib4 index were significantly associated with the incidence of gastric neoplasms. Several metabolic disorders, including DM, hypertension, dyslipidemia, hyperuricemia, and fatty liver disease, are risk factors for advanced-grade gastric atrophy, intestinal metaplasia, and gastric neoplasms. Risk stratification according to these factors, particularly those with metabolic disorders, would affect EGD surveillance for Helicobacter pylori-positive patients.

Comparison between the GastroPanel test and the serum pepsinogen assay interpreted with the ABC method-A prospective study.

This study aimed to validate Helicobacter pylori serological and pepsinogen (PG) assays for detecting infection and gastric neoplasm. Individuals who underwent serum Chorus H. pylori and HBI PG assays were included from May to September 2023. The GastroPanel test was performed using the same blood sample. HBI assay findings were interpreted with the ABC method using the criteria of corpus atrophy (PG I ≤ 70 ng/mL & I/II ≤3) and advanced corpus atrophy (PG I ≤ 30 ng/mL & I/II ≤2). A total of 144 H. pylori-infected and 184 non-infected Koreans were analyzed. The Chorus test (sensitivity 97.2%, specificity 89.1%) showed higher area under the curve (0.993 vs. 0.972, p = 0.003) than the GastroPanel test (sensitivity 95.8%, specificity 86.4%). Using the GastroSoft application, the incidence of gastric neoplasms was highest in the corpus atrophy group (50%), followed by the low acid-output (25.8%), H. pylori infection (11.6%), and antral atrophy (9.1%) groups. There were no gastric neoplasms in the normal and high acid output groups. Using the ABC method, the incidence of gastric neoplasms was highest in the corpus atrophy groups (23.8% in Groups C and D), followed by Group B (12.3%) and Group A (2.4%). Corpus atrophy interpreted with the GastroSoft showed poor agreement (k = 0.225) with corpus atrophy interpreted with the ABC method, whereas it showed excellent agreement (k = 0.854) with advanced corpus atrophy. Although the Chorus test was more accurate than the GastroPanel test, both assays discriminated high-risk individuals by detecting atrophy or infection. There were no gastric neoplasms in the normal or high acid-output groups (GastroSoft application), and gastric neoplasm incidence was lowest in Group A (ABC method). Corpus atrophy determined by GastroSoft application is more consistent with advanced corpus atrophy determined by the ABC method than is corpus atrophy.

Su1981 The Role of H. Pylori Eradication for the Prevention of Metachronous Lesions After Endoscopic Resection in Gastric Neoplasms

Background: Combining serum pepsinogen (PG) levels and Helicobacter pylori antibody test is useful for detecting high-risk population for gastric neoplasm. We tried to uncover whether this combinationmethod can predict the incidence and histology of gastric neoplasm. Methods: This study included 3946 asymptomatic Korean adults who underwent esophagogastroduodenoscopy with blood testing for PG levels and H. pylori antibody on the same day at our center. Subjects with extragastric malignancy, a history of H. pylori eradication or gastric neoplasm, or recent antacid medication were excluded. Gastric atrophy was defined as serum PG I of ≤ 70 ng/ml and PG I/II ratio of ≤ 3.0. The subjects were classified into four groups according to the presence (+) and absence (-) of gastric atrophy and H. pylori infection. Results: Of the 3328 included subjects, 17 were incidentally diagnosed as having either gastric adenoma or carcinoma. While the incidence of gastric neoplasm was highest in the gastric atrophy(+)/H. pylori(-) group (4.17%; odds ratio=25.8; p=0.009), this group exhibited the least advanced histology, such as gastric adenoma with low-grade dysplasia (LGD). The gastric atrophy(-)/H. pylori(-) group exhibited the lowest incidence of gastric neoplasm (0.17%) but the most-advanced histology, such as poorly cohesive carcinoma and adenoma with high-grade dysplasia. Conclusions: Combining serum PG levels and H. pylori antibody testing is useful for detecting gastric neoplasms progressing from gastric adenoma with LGD to differentiated, Lauren's intestinal-type gastric cancer based on the slow gastric carcinogenesis pathway. However, this method is not useful for detecting gastric neoplasms with advanced histology.

Su1980 Combining the Serum Pepsinogen Levels and Helicobacter pylori Antibody Test Is Not Useful for Detecting Gastric Neoplasms With Advanced Histology

Background: Combining serum pepsinogen (PG) levels and Helicobacter pylori antibody test is useful for detecting high-risk population for gastric neoplasm. We tried to uncover whether this combinationmethod can predict the incidence and histology of gastric neoplasm. Methods: This study included 3946 asymptomatic Korean adults who underwent esophagogastroduodenoscopy with blood testing for PG levels and H. pylori antibody on the same day at our center. Subjects with extragastric malignancy, a history of H. pylori eradication or gastric neoplasm, or recent antacid medication were excluded. Gastric atrophy was defined as serum PG I of ≤ 70 ng/ml and PG I/II ratio of ≤ 3.0. The subjects were classified into four groups according to the presence (+) and absence (-) of gastric atrophy and H. pylori infection. Results: Of the 3328 included subjects, 17 were incidentally diagnosed as having either gastric adenoma or carcinoma. While the incidence of gastric neoplasm was highest in the gastric atrophy(+)/H. pylori(-) group (4.17%; odds ratio=25.8; p=0.009), this group exhibited the least advanced histology, such as gastric adenoma with low-grade dysplasia (LGD). The gastric atrophy(-)/H. pylori(-) group exhibited the lowest incidence of gastric neoplasm (0.17%) but the most-advanced histology, such as poorly cohesive carcinoma and adenoma with high-grade dysplasia. Conclusions: Combining serum PG levels and H. pylori antibody testing is useful for detecting gastric neoplasms progressing from gastric adenoma with LGD to differentiated, Lauren's intestinal-type gastric cancer based on the slow gastric carcinogenesis pathway. However, this method is not useful for detecting gastric neoplasms with advanced histology.

Operative Treatment of Patients Over 75 Years Old with Gastric Cancer

Purpose: The incidence of gastric neoplasms is increasing in the elderly population, and a rational method of treatment for gastric cancer in the elderly is needed to improve survival. The purpose of the present study was to clarify whether the patient's age is an independent prognostic factor and to determine clinicopathological characteristics in the elderly. Material and Methods: Curative or palliative surgery for gastric cancer was carried out on 706 patients in Chosun University Hospital from March 1995 to February 2002. They were divided into the following two groups: elderly group (75 years or older) and control group (under 74 years old). The clinicopathologic features of these patients were reviewed retrospectively, and a multivariate analysis was performed. Results: There was no difference in clinicopathological appearances between the two groups, and the postoperative morbidity and mortality rates were similar in the two groups. The two groups showed similar survival rates. Conclusion: In this study, age was not a prognostic factor in surgery for gastric cancer. In the elderly, an oncologically correct surgical procedure can safely be prosecuted with satisfactory early and late results.

Gastric resection in the aged (> or = 80 years) with gastric carcinoma: a multivariate analysis of prognostic factors.

The incidence of gastric neoplasm is increasing in the elderly population. Therefore, a rational method of treatment for gastric cancer in the elderly should be constituted to improve the survival. The purpose of the present study was to clarify whether the patient's age is an independent prognostic factor and to determine clinicopathological characteristics in the elderly. Curative resection of gastric cancer was carried out on 601 patients who were 40 years or older. They were divided into the following two groups: younger patients (between 40 and 79 years old) and elderly patients (80 years or older). The clinicopathologic features of these patients were reviewed retrospectively and multivariate analysis was carried out. The distinguishing features of gastric cancer in the elderly patients were intestinal and mixed types of cancer, distal third stomach dominance in the tumour location, advanced stage of disease, and a low rate of extensive lymph node dissection (D3 or more). Regarding the recurrence site, the liver was the dominant site in the elderly group (25.3% in the younger group vs 54.5% in the elderly group). The 10-year disease-free survival rate of the elderly group was 53.2%, which was significantly worse than that (79.9%) of the younger patients (P = 0.0004). In multivariate analysis, an age of > or = 80 years is an independent prognostic factor, as well as stage, depth of tumour invasion, lymph node metastasis, scirrhous carcinoma, and blood transfusion. Results indicate that gastric cancer in elderly patients has a poorer prognosis than that in younger patients.