Preneoplastic Gastric Lesions and Helicobacter Pylori in Endoscopic Detection and Early Diagnosis of Gastric Cancer in Lebanese Population. A Retrospective Study from 2019-2020

Abstract

Background: Gastric cancer (GC) ranks as the fifth leading cause of cancer worldwide and is the fourth leading cause of cancer mortality. Premalignant gastric lesions (PGL) are considered as the most significant risk factor for GC. The purpose of this study was to determine the prevalence, characteristics, and risk factors of premalignant gastric lesions among Lebanese patients. Methods:This was a retrospective study conducted among patients admitted to the endoscopy units of the Rafic Hariri University Hospital (RHUH) and Bahman Hospital in Lebanon between Jan 2019 and Dec 2020. Medical information including gastric pathology, type of PGL, indication of endoscopy, endoscopic findings and H. pylori infection were obtained from the medical records of all patients. A total of 2400 patients were initially identified and used to calculate the prevalence of PGL. Patients were then contacted by phone to obtain demographic data, smoking status, alcohol consumption, family history of GC, and lifestyle characteristics. We managed to collect 1062 responses. A binary logistic regression was done to determine the risk factors of PGL.Results: Out of 2,400 patients having undergone gastric endoscopy with gastric biopsies, 218 were identified with PGL giving it a prevalence of 9.8%. Atrophic gastritis was the most frequently identified PGL (68%), followed by intestinal metaplasia (30%). The mean age of our final population (1064 patients) was 53.03 (±18.01) years. H. pylori infection was found among 44% of them. The most common indication for gastric endoscopy was abdominal pain (28%), followed by dyspepsia (25%). Erythema was the most common finding (51%), followed by erosions (19%). Binary regression analysis showed that older age (≥ 40 years) (ORa = 3.06), family history of GC (ORa = 10.79), alcohol consumption (ORa = 9.21), and H. pylori (ORa = 4.95)