Predictors for regression and progression of intestinal metaplasia (IM): A large population-based study from low prevalence area of gastric cancer (IM-predictor trial).

<h4>Background</h4>Gastric intestinal metaplasia (IM) can lead to gastric cancer. Until now, there have been limited studies of predictors for regression and progression of IM. This study aimed to determine risk factors associated with regression or progression of IM for guiding proper m...

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Autores principales:	Natsuda Aumpan, Ratha-Korn Vilaichone, Bubpha Pornthisarn, Soonthorn Chonprasertsuk, Sith Siramolpiwat, Patommatat Bhanthumkomol, Pongjarat Nunanan, Navapan Issariyakulkarn, Sarita Ratana-Amornpin, Muhammad Miftahussurur, Varocha Mahachai, Yoshio Yamaoka
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a356364af0bf4386be9ccdd0007ccee0
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spelling	oai:doaj.org-article:a356364af0bf4386be9ccdd0007ccee02021-12-02T20:18:25ZPredictors for regression and progression of intestinal metaplasia (IM): A large population-based study from low prevalence area of gastric cancer (IM-predictor trial).1932-620310.1371/journal.pone.0255601https://doaj.org/article/a356364af0bf4386be9ccdd0007ccee02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255601https://doaj.org/toc/1932-6203<h4>Background</h4>Gastric intestinal metaplasia (IM) can lead to gastric cancer. Until now, there have been limited studies of predictors for regression and progression of IM. This study aimed to determine risk factors associated with regression or progression of IM for guiding proper management and prevention of gastric cancer.<h4>Methods</h4>2,025 patients undergoing gastroscopy in Thammasat University Hospital, Thailand were enrolled during September 2017-August 2019. Patients' data including baseline characteristics, laboratory results, and histopathology of gastric biopsies from University medical database were extensively reviewed.<h4>Results</h4>2,025 patients had mean age of 61.3 years and 44.2% were males. Overall H. pylori prevalence was 47.5%. There were 1,551(76.6%) patients with chronic gastritis and 361(17.8%) with IM. Of 400 patients with chronic gastritis having follow-up endoscopy and repeated gastric biopsies, 104(26%) had persistent H. pylori infection and 27(26%) developed IM during mean follow-up time of 24 months. Persistent H. pylori infection was significantly associated with development of IM (OR 3.16, 95%CI 1.56-6.39, p = 0.001). Regression, persistence, and progression of IM were demonstrated in 57.3%, 39.2%, and 3.5% of patients, respectively. Age >65 years, persistent H. pylori infection, and diabetes mellitus were significantly associated with persistent IM or progression to dysplasia with OR 2.47(95%CI 1.33-4.61, p = 0.004), OR 2.64(95%CI 1.13-6.18, p = 0.025), and OR 2.54(95%CI 1.16-5.54, p = 0.019), respectively. Patients without H. pylori infection had more IM regression than patients with persistent infection (60.4%vs.39.4%, p = 0.035). Patients with persistent H. pylori infection significantly had higher IM progression to dysplasia (15.2%vs.2.1%; OR 11.15, 95%CI 1.18-105.24, p = 0.035) than noninfected. During 24 months of study, 30 patients (1.5%) were diagnosed with gastric cancer.<h4>Conclusion</h4>Regression of IM could be achieved by successful H. pylori eradication. Persistent H. pylori infection was significantly associated with development and progression of IM to dysplasia. Age >65 years and diabetes mellitus were also significant predictors for IM progression.Natsuda AumpanRatha-Korn VilaichoneBubpha PornthisarnSoonthorn ChonprasertsukSith SiramolpiwatPatommatat BhanthumkomolPongjarat NunananNavapan IssariyakulkarnSarita Ratana-AmornpinMuhammad MiftahussururVarocha MahachaiYoshio YamaokaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255601 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Natsuda Aumpan Ratha-Korn Vilaichone Bubpha Pornthisarn Soonthorn Chonprasertsuk Sith Siramolpiwat Patommatat Bhanthumkomol Pongjarat Nunanan Navapan Issariyakulkarn Sarita Ratana-Amornpin Muhammad Miftahussurur Varocha Mahachai Yoshio Yamaoka Predictors for regression and progression of intestinal metaplasia (IM): A large population-based study from low prevalence area of gastric cancer (IM-predictor trial).
description	<h4>Background</h4>Gastric intestinal metaplasia (IM) can lead to gastric cancer. Until now, there have been limited studies of predictors for regression and progression of IM. This study aimed to determine risk factors associated with regression or progression of IM for guiding proper management and prevention of gastric cancer.<h4>Methods</h4>2,025 patients undergoing gastroscopy in Thammasat University Hospital, Thailand were enrolled during September 2017-August 2019. Patients' data including baseline characteristics, laboratory results, and histopathology of gastric biopsies from University medical database were extensively reviewed.<h4>Results</h4>2,025 patients had mean age of 61.3 years and 44.2% were males. Overall H. pylori prevalence was 47.5%. There were 1,551(76.6%) patients with chronic gastritis and 361(17.8%) with IM. Of 400 patients with chronic gastritis having follow-up endoscopy and repeated gastric biopsies, 104(26%) had persistent H. pylori infection and 27(26%) developed IM during mean follow-up time of 24 months. Persistent H. pylori infection was significantly associated with development of IM (OR 3.16, 95%CI 1.56-6.39, p = 0.001). Regression, persistence, and progression of IM were demonstrated in 57.3%, 39.2%, and 3.5% of patients, respectively. Age >65 years, persistent H. pylori infection, and diabetes mellitus were significantly associated with persistent IM or progression to dysplasia with OR 2.47(95%CI 1.33-4.61, p = 0.004), OR 2.64(95%CI 1.13-6.18, p = 0.025), and OR 2.54(95%CI 1.16-5.54, p = 0.019), respectively. Patients without H. pylori infection had more IM regression than patients with persistent infection (60.4%vs.39.4%, p = 0.035). Patients with persistent H. pylori infection significantly had higher IM progression to dysplasia (15.2%vs.2.1%; OR 11.15, 95%CI 1.18-105.24, p = 0.035) than noninfected. During 24 months of study, 30 patients (1.5%) were diagnosed with gastric cancer.<h4>Conclusion</h4>Regression of IM could be achieved by successful H. pylori eradication. Persistent H. pylori infection was significantly associated with development and progression of IM to dysplasia. Age >65 years and diabetes mellitus were also significant predictors for IM progression.
format	article
author	Natsuda Aumpan Ratha-Korn Vilaichone Bubpha Pornthisarn Soonthorn Chonprasertsuk Sith Siramolpiwat Patommatat Bhanthumkomol Pongjarat Nunanan Navapan Issariyakulkarn Sarita Ratana-Amornpin Muhammad Miftahussurur Varocha Mahachai Yoshio Yamaoka
author_facet	Natsuda Aumpan Ratha-Korn Vilaichone Bubpha Pornthisarn Soonthorn Chonprasertsuk Sith Siramolpiwat Patommatat Bhanthumkomol Pongjarat Nunanan Navapan Issariyakulkarn Sarita Ratana-Amornpin Muhammad Miftahussurur Varocha Mahachai Yoshio Yamaoka
author_sort	Natsuda Aumpan
title	Predictors for regression and progression of intestinal metaplasia (IM): A large population-based study from low prevalence area of gastric cancer (IM-predictor trial).
title_short	Predictors for regression and progression of intestinal metaplasia (IM): A large population-based study from low prevalence area of gastric cancer (IM-predictor trial).
title_full	Predictors for regression and progression of intestinal metaplasia (IM): A large population-based study from low prevalence area of gastric cancer (IM-predictor trial).
title_fullStr	Predictors for regression and progression of intestinal metaplasia (IM): A large population-based study from low prevalence area of gastric cancer (IM-predictor trial).
title_full_unstemmed	Predictors for regression and progression of intestinal metaplasia (IM): A large population-based study from low prevalence area of gastric cancer (IM-predictor trial).
title_sort	predictors for regression and progression of intestinal metaplasia (im): a large population-based study from low prevalence area of gastric cancer (im-predictor trial).
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/a356364af0bf4386be9ccdd0007ccee0
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Predictors for regression and progression of intestinal metaplasia (IM): A large population-based study from low prevalence area of gastric cancer (IM-predictor trial).

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