Anatomical predilection of intestinal metaplasia based on 78,335 endoscopic cases

Mao, Xin-Yi; Xu, Shaofa; Liu, Qing; Jiang, Jianxia; Zhang, Haihan; Sang, Huaiming; Zhang, Guoxin

doi:10.4103/1319-3767.178528

Cited by 12 publications

(2 citation statements)

References 17 publications

(21 reference statements)

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Section: Discussionmentioning

confidence: 93%

“…As for sites of lesions, AG, and IM were found most frequently at the angle, lesser curvatures of antrum and corpus in order, and less occurred on fundus, greater curvatures of antrum and corpus. [74][75][76][77] Antrum and corpus may be different in mRNA expression, change patterns of morphometric features and function of acid secretion during the precancerous lesions, [78][79][80] which may lead to significant difference in improvement of AG or IM in the antrum versus corpus, but could not explain the nonsignificant difference in the improvement of AG or IM in the antrum versus corpus after H. pylori eradication. In addition, four studies included in this meta-analysis showed that the improvement of AG and IM discriminated in the greater curvature and the lesser curvature, 36,39,43,81 and all the studies included in this meta-analysis supported that improvement of AG and IM after H. pylori eradication in greater curvature was more significant than in lesser curvature.…”

Section: Discussionmentioning

confidence: 99%

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Do atrophic gastritis and intestinal metaplasia reverse after Helicobacter pylori eradication?

Liang,

Yang,

Nong

et al. 2023

Helicobacter

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BackgroundIt's still controversial whether Helicobacter pylori (H. pylori) eradication can reverse atrophic gastritis (AG) and intestinal metaplasia (IM). Therefore, we performed a meta‐analysis to estimate the effect of H. pylori eradication on AG and IM.MethodsWe searched the PubMed, Web of Science and EMBASE datasets through April 2023 for epidemiological studies, which provided mean glandular atrophy (GA) or IM score before and after H. pylori eradication, or provided ORs, RRs or HRs and 95% CIs for the association of AG or IM with H. pylori eradication. Weighted mean difference (WMD) and pooled ORs and 95%CIs were used to estimate the effect of H. pylori eradication on AG and IM.ResultsTwenty articles with a total of 5242 participants were included in this meta‐analysis. H. pylori eradication significantly decreased GA score in the antrum (WMD −0.36; 95% CI: −0.52, −0.19, p < 0.01), GA score in the corpus (WMD −0.35; 95% CI: −0.52, −0.19, p < 0.01), IM score in the antrum (WMD −0.16; 95% CI: −0.26, −0.07, p < 0.01) and IM score in the corpus (WMD −0.20; 95% CI: −0.37, −0.04, p = 0.01). H. pylori eradication significantly improved AG (pooled OR 2.96; 95% CI: 1.70, 5.14, p < 0.01) and IM (pooled OR 2.41; 95% CI: 1.24, 4.70, p < 0.01). The association remained significant in the subgroup analyses by study design, sites of lesions, regions and follow‐up time. Although Publication bias was observed for AG, the association remained significant after trim‐and‐fill adjustment.ConclusionsH. pylori eradication could significantly improve AG and IM at early stage.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Do atrophic gastritis and intestinal metaplasia reverse after Helicobacter pylori eradication?

Liang,

Yang,

Nong

et al. 2023

Helicobacter

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Helicobacter Pylori Infection Prevalence and Histopathologic Findings in Laparoscopic Sleeve Gastrectomy

Turan

Kocaöz

2019

OBES SURG

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Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019

et al. 2019

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Main RecommendationsPatients with chronic atrophic gastritis or intestinal metaplasia (IM) are at risk for gastric adenocarcinoma. This underscores the importance of diagnosis and risk stratification for these patients. High definition endoscopy with chromoendoscopy (CE) is better than high definition white-light endoscopy alone for this purpose. Virtual CE can guide biopsies for staging atrophic and metaplastic changes and can target neoplastic lesions. Biopsies should be taken from at least two topographic sites (antrum and corpus) and labelled in two separate vials. For patients with mild to moderate atrophy restricted to the antrum there is no evidence to recommend surveillance. In patients with IM at a single location but with a family history of gastric cancer, incomplete IM, or persistent Helicobacter pylori gastritis, endoscopic surveillance with CE and guided biopsies may be considered in 3 years. Patients with advanced stages of atrophic gastritis should be followed up with a high quality endoscopy every 3 years. In patients with dysplasia, in the absence of an endoscopically defined lesion, immediate high quality endoscopic reassessment with CE is recommended. Patients with an endoscopically visible lesion harboring low or high grade dysplasia or carcinoma should undergo staging and treatment. H. pylori eradication heals nonatrophic chronic gastritis, may lead to regression of atrophic gastritis, and reduces the risk of gastric cancer in patients with these conditions, and it is recommended. H. pylori eradication is also recommended for patients with neoplasia after endoscopic therapy. In intermediate to high risk regions, identification and surveillance of patients with precancerous gastric conditions is cost-effective.

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Anatomical predilection of intestinal metaplasia based on 78,335 endoscopic cases

Cited by 12 publications

References 17 publications

Do atrophic gastritis and intestinal metaplasia reverse after Helicobacter pylori eradication?

Do atrophic gastritis and intestinal metaplasia reverse after Helicobacter pylori eradication?

Helicobacter Pylori Infection Prevalence and Histopathologic Findings in Laparoscopic Sleeve Gastrectomy

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