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First endoscopic-histologic follow-up in patients with body-predominant atrophic gastritis: When should it be done?

2001; Elsevier BV; Volume: 53; Issue: 4 Linguagem: Inglês

10.1067/mge.2001.112189

1097-6779

Edith Lahner, Pietro Caruana, Giancarlo D’Ambra, Gabriella Ferraro, Emilio Di Giulio, Gianfranco Delle Fave, Cesare Bordi, Bruno Annibale,

Gastrointestinal disorders and treatments

Abstract Background: Body-predominant atrophic gastritis is considered a risk factor for gastric cancer and carcinoid. Timing of follow-up for patients with this disorder has not been defined. This study was undertaken to determine the optimal time for the first endoscopic/histologic follow-up in patients with body-predominant atrophic gastritis. Methods: Forty-two patients with body-predominant atrophic gastritis were randomly assigned to 1 of 2 follow-up intervals: group A (n = 22) at 24 months and group B (n = 20) at 48 months. At baseline and follow-up patients underwent gastroscopy at which biopsies were obtained from the antrum and body for histopathology and evaluation for enterochromaffin-like cells. Results: In group A patients, 2 antral hyperplastic polyps (9.1%) were present at baseline and 4 antral hyperplastic polyps (18.2%) were found at follow-up. In group B patients, baseline gastroscopy revealed 2 antral hyperplastic polyps (10%) and follow-up 2 antral hyperplastic polyps (10%) and 1 carcinoid tumor (5%) in the body. Atrophy and intestinal metaplasia scores in gastric body and antral mucosa in both groups did not change significantly between baseline and follow-up, except an increase in antral mucosa atrophy in group B patients ( p = 0.02) was revealed. Conclusions: The results of this study indicate that performing the first follow-up in patients with body—predominant atrophic gastritis need not be earlier than at 4 years after diagnosis. This interval is satisfactory for detection of potential neoplastic lesions. (Gastrointest Endosc 2001;53:443-8.)