Endoscopy 2019; 51(04): S21
DOI: 10.1055/s-0039-1681229
ESGE Days 2019 oral presentations
Friday, April 5, 2019 08:30 – 10:30: Stomach diagnosis Club C
Georg Thieme Verlag KG Stuttgart · New York

FACTORS ASSOCIATED WITH THE PROGRESSION OF GASTRIC INTESTINAL METAPLASIA IN A LOW RISK POPULATION – A MULTICENTER, PROSPECTIVE COHORT STUDY

SAV Nieuwenburg
1   Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, Netherlands
,
MC Mommersteeg
1   Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, Netherlands
,
TJ Tang
2   Gastroenterology & Hepatology, Ijsselland Hospital, Capelle a/d Ijsel, Netherlands
,
MP Anten
3   Gastroenterology & Hepatology, Sint Fransiscus Hospital, Rotterdam, Netherlands
,
I Prytz-Berset
4   Gastroenterology & Hepatology, More and Romsdal Trust, Alesund, Norway
,
E Witteman
5   Gastroenterology & Hepatology, Canisius Wilhelmina Hospital, Nijmegen, Netherlands
,
F ter Borg
6   Gastroenterology & Hepatology, Deventer Hospital, Deventer, Netherlands
,
GD den Hartog
7   Gastroenterology & Hepatology, Rijnstate, Arnhem, Netherlands
,
MJ Bruno
1   Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, Netherlands
,
MP Peppelenbosch
1   Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, Netherlands
,
M Doukas
8   Pathology, Erasmus University Medical Center, Rotterdam, Netherlands
,
EJ Kuipers
1   Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, Netherlands
,
MCW Spaander
1   Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, Netherlands
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Gastric cancer (GC) is preceded by several gastric precursor lesions (GPL) which makes it suitable for surveillance. For low risk areas method and frequency of endoscopic surveillance is still under debate. This study aims to identify high and low risk subjects for progression of GPL to prevent unnecessary performed endoscopies. Patient characteristics and previously described discriminative serum markers at baseline (pepsinogens (PG) and gastrin-17) are assessed to predict progression of PGL.

Methods:

The PROREGAL study started in 2009 and is one of the largest prospective cohorts in the Netherlands and Norway. Inclusion: 1) > 18 years of age, 2) previous diagnosis of GPL. Patients completed a questionnaire on lifestyle factors and underwent at least two endoscopies. Biopsies were obtained from visible lesions and 12 standardised stomach sites and assessed according to the operative link on gastric intestinal metaplasia (OLGIM) system. At baseline, PG and gastrin-17 samples were drawn. Progression of IM was defined as progression of OLGIM classification between follow-up (FU) endoscopy. Cox-regression was performed with a significance level of 0.05.

Results:

308 patients (median age 61 years, IQR17;male 48.4%) were included. Median FU time was 48 months (IQR 24). During FU 116 patients showed progression of OLGIM stage (37.7%) providing an incidence rate of 9 events/100 personyears (95% CI 8.8 – 9.2). Six patients (1.9%) developed GC (0.4 events/100 personyears (95% CI 0.002 – 0.01)). History of Hp-infection, smoking, alcohol use and increased BMI did not show significant associations. Also serum levels of PG I/II, and gastrin-17 were not significantly correlated with progression of IM.

Conclusions:

This is the first study to assess RF for the progression of IM in low risk areas. Lifestyle factors were not correlated with progression of IM. Moreover, baseline serum markers are not predictive for future progression of IM during FU. Future studies should focus on the longitudinal assessment of these markers.