Family History of Gastric Cancer and the Risk of Progression of Gastric Premalignant Conditions: A Prospective, 10-Year Endoscopic Follow-up Study

Aims We aimed to evaluate the progression of gastric precancerous conditions and the incidence of gastric dysplasia/neoplasia in first-degree relatives of gastric cancer patients.

Methods We performed a single-centre, 10-year prospective follow-up cohort study, enrolling first-degree relatives (FDR) of early-onset gastric cancer (EOGC) patients. All individuals were submitted to high-definition upper endoscopy with white-light and narrow-band imaging evaluation, gastric biopsies according to the updated Sydney system protocol, OLGA and OLGIM stage evaluation and H. pylori infection at inclusion –T0 and at year 10 (T10).

Results We enrolled 100 FDR at T0; of these 50 FDR were included at T1: 66.0 % females, with a mean age of 51.4±12.8 years. At baseline(T0), 74.0 % had H. pylori infection and 18.0 %/14.0 % had high-risk (III/IV) OLGA/OLGIM stages, respectively. The median time between the first (T0) and the follow-up endoscopy (T10) was 9.87±0.55 years.

In the follow-up endoscopy (T10) we found extensive intestinal metaplasia (EGGIM score ≥5), high-risk OLGA and OLGIM stages in 14.0 %, 14.0 % and 16.0 % of the patients, respectively. H. pylori infection was detected in 48.0 % of the patients. OLGIM stage remained unchanged in 30 patients (60.0 %) whereas 11 patients (22.0 %) had OLGIM stage progression, However, only two patients progressed from low-risk to high-risk stages, both with persistent H. pylori infection (not eradicated).

Overall, OLGA and OLGIM stages were not significantly different from T0 and T10. However, in subgroup analysis, patients with OLGIM progression were older (57.5±10.3 vs 49.6±13.1 years, p = 0.05) and all over 40 years old (30.6 % vs 0.00 %, p = 0.019), at T10. OLGIM stage progression was more frequent in H. pylori positive patients (29.2 % vs 15.4 %, p = 0.144). No gastric dysplasia was diagnosed.

Conclusions In a follow-up period of ~10 years, we showed a progression of OLGIM stages among first-degree relatives of gastric cancer patients over 40 years, with persistent H. pylori infection.

Citation: Garrido M, Viscaíno JR, Dinis-Ribeiro M et al. OP49 FAMILY HISTORY OF GASTRIC CANCER AND THE RISK OF PROGRESSION OF GASTRIC PREMALIGNANT CONDITIONS: A PROSPECTIVE, 10-YEAR ENDOSCOPIC FOLLOW-UP STUDY. Endoscopy 2021; 53: S22.

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Artikel online veröffentlicht:
19. März 2021