Curr Health Sci J, vol. 35, no. 2, 2009

The Influence of Risk Factors to the Prevalence of Gastric Mucosal Atrophy, Intestinal Metaplasia and Dysplasia in Oltenia Region

[Original paper]

S. M. Cazacu(1), C.C. Vere(1), N. Bodrug(2), D.I. Gheonea(1), Violeta Comanescu(3), T. Ciurea(1)

(1)Department of-Gastroenterology, County Emergency Hospital Craiova, University of Medicine and Pharmacy, Craiova;
(2) Department of Internal Medicine, Hospital of Chisinau,
(3)Department of Pathology, Emergency University Hospital, Craiova


Background &aims Gastric atrophy and intestinal metaplasia represent the most important premalignant lesions in gastric carcinogenesis (risk 1.1% / year). Although H. pylori infection has a major role, the prevalence and severity of mucosal atrophy and intestinal metaplasia at Helicobacter positive patients is variable, which suggest other factors except H. pylori infection may play an important role. Method. We performed a prospective, case-control study at patient admitted in a tertiary care unit (Ist Medical Clinic, Emergency Hospital Craiova) and examined by endoscopy during 3 years. We selected 1432 patients with chronic gastrites or gastropathies by endoscopic examination; atrophy and intestinal metaplasia were confirmed by pathologic exam. We analyzed the prevalence of risk factors by comparing patients with atrophy and intestinal metaplasia with patients without these abnormalities. ResultsThe presence of IgG anti-HP antibodies was associated with increased risk of superficial (OR=1.711) and atrophic gastritis (OR=1.744). At patients with gastric atrophy diagnosed by endoscopy, OR has statistical significant risk for age above 50 years (OR=8.54, CI 95% 2.95-14.42), for rural residence (OR=2.47), smoking habit (8,821) and alcohol consumption, whereas NSAID use was associated with some protective effect. For intestinal metaplasia, a statistically significant risk was noted above 60 years, rural residence (OR=3.25), smoking habit (2, 8947) and alcohol consumption. Endoscopic-diagnosed atrophy has proved a mild to moderate sensibility for the detection of atrophy at pathological examination. Conclusions Helicobacter pylori infection, age, rural residence, smoking habit and alcohol consumption were associated with increased risk of gastric atrophy and intestinal metaplasia.

gastritis, gastric atrophy, intestinal metaplasia, Helicobacter pylori, NSAID, chromoendoscopy

Assoc Prof S. M. Cazacu MD, PhD, Department of-Gastroenterology, County Emergency Hospital Craiova, University of Medicine and Pharmacy

DOI 10.12865/CHSJ.35.02.03 - Download PDF