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Occurrence andpredictors ofmetaplastic atrophicgastritis in anation-wideconsecutiveendoscopic populationpresenting with uppergastrointestinalsymptoms Edith LahnerMarilia CarabottiGianluca Esposito2018 год

Occurrence and predictors of metaplastic atrophic gastritis in a nation-wide consecutive endoscopic population presenting with upper gastrointestinal symptoms
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Аннотация: Objectives The frequency of metaplastic atrophic gastritis in noninvestigated dyspepsia and its associated symptoms pattern are not known. This study aimed to assess the occurrence and clinical predictors of metaplastic atrophic gastritis in a consecutive endoscopic population presenting with upper gastrointestinal symptoms. Patients and methods A post-hoc cross-sectional study was carried out on endoscopic-histological data from 668 patients (64% women, age: 58 years) with upper gastrointestinal symptoms obtained during a multicenter study. Patients with dyspeptic (46%), reflux-like symptoms (22%), and both (32%) as indications for gastroscopy were included. Gastroscopy with biopsies (Sydney System) was performed. Clinical data and symptoms were collected using a structured questionnaire. Results Metaplastic atrophic gastritis was detected in 201 (30.1%) patients: 22.3% antrum-restricted, 4.5% corpus-restricted, and 3.3% extensive. Postprandial fullness was more frequent in patients with metaplastic atrophic gastritis compared with those without metaplastic atrophic gastritis (29.8 vs. 18.8%, P =0.002); epigastric pain/burning, early satiety, and reflux symptoms occurred similarly in both groups. At multivariate logistic regression, metaplastic atrophic gastritis (any site) was associated with age older than 55 years [odds ratio (OR): 1.86, 95% confidence interval (CI): 1.26–2.73], Helicobacter pylori (OR: 1.66, 95% CI: 1.1–2.39), postprandial fullness (OR: 1.62, 95% CI: 1.03–2.54), and smoking (OR: 1.53, 95% CI: 1.02–2.31). Corpus-restricted atrophic gastritis was associated with postprandial fullness (OR: 4.16, 95% CI: 1.79–9.63) and NSAIDs (OR: 2.98, 95% CI: 1.01–8.88), extensive and antrum-restricted atrophic gastritis was associated with age older than 55 (OR 3.6, 95% CI: 1.20–12.67 and OR: 1.63, 95% CI: 1.06–2.49). Conclusion Metaplastic atrophic gastritis, a preneoplastic condition, may be found in about one of three patients undergoing endoscopy for upper gastrointestinal symptoms, and clinical predictors are age older than 55 years, smoking, H. pylori infection, and postprandial fullness, especially for corpus-restricted metaplastic atrophic gastritis. An accurate pre-endoscopic characterization of patients with upper gastrointestinal symptoms with easily achievable clinical information may help to better address an endoscopic investigation.
Год издания: 2018
Авторы: Edith Lahner, Marilia Carabotti, Gianluca Esposito, Cesare Hassan, Angelo Zullo, Bruno Annibale
Издательство: Lippincott Williams & Wilkins
Источник: European Journal of Gastroenterology & Hepatology
Ключевые слова: Helicobacter pylori-related gastroenterology studies, Gastroesophageal reflux and treatments, Eosinophilic Esophagitis
Другие ссылки: European Journal of Gastroenterology & Hepatology (HTML)
PubMed (HTML)