The corpus-predominant gastritis index may serve as an early marker of Helicobacter pylori-infected patients at risk of gastric cancer
Article first published online: 2 APR 2013
© 2013 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 37, Issue 10, pages 969–978, May 2013
How to Cite
Aliment Pharmacol Ther 2013; 37: 969–978
- Issue published online: 17 APR 2013
- Article first published online: 2 APR 2013
- Manuscript Revised: 7 MAR 2013
- Manuscript Accepted: 7 MAR 2013
- Manuscript Revised: 23 JAN 2013
- Manuscript Received: 7 JAN 2013
- 98-2628-B-006-013-MY3 & 101-2314-B-006-016-MY3. Grant Number: 98-2628-B-006-013-MY3 & 101-2314-B-006-016-MY3
- 98-2628-B-006-013-MY3 & 101-2314-B-006-016-MY3
- National Scientific Council. Grant Number: NHRI-EX99-9908BI
- National Health Research Institute. Grant Number: DOH100-TD-C-111-003
- Department of Health
To eradicate Helicobacter pylori before the occurrence of precancerous changes is important to prevent gastric carcinogenesis.
To validate whether the corpus-predominant gastritis index (CGI) can serve as an early marker to identify the H. pylori-infected patients at risk of gastric carcinogenesis.
This study enrolled 188 subjects, including 43 noncardiac gastric cancer patients, 63 of their first-degree relatives and 82 sex- and age-matched duodenal ulcer patients as controls. All received endoscopy to provide topographic gastric specimens to test for H. pylori infection and its related histological features, translated into the operative link on gastritis assessment (OLGA), operative link on gastric intestinal metaplasia assessment (OLGIM) stages, and the presence of CGI. Spasmolytic polypeptide-expressing metaplasia (SPEM) was assessed by immunohistochemistry staining of trefoil factor 2.
Gastric cancer patients had higher prevalence of CGI and OLGIM stage II–IV, but not OLGA stage II–IV, than the controls (P = 0.001, OR = 3.4[95% CI: 1.4–8.1] for CGI; OR = 5.0[95% CI: 2.0–12.8] for OLGIM). In patients with the combined presence of CGI and OLGIM stage II–IV, the risk of gastric cancer increased to 9.8 (P < 0.001). The first-degree relatives of the gastric cancer patients had a higher rate of the presence of CGI, but not OLGA or OLGIM stage II–IV than the duodenal ulcer controls (P = 0.001). Of the first-degree relatives, the presence of CGI increased the risk of SPEM (P = 0.003, OR = 5.5[95% CI: 1.8–17.0]).
The corpus-predominant gastritis index, which is highly correlated to SPEM, may serve as an early marker to identify the H. pylori-infected patients at a higher risk of gastric cancer.