Objective: In the USA, detection of intestinal metaplasia is a requirement for enrollment in surveillance programmes for dysplasia or adenocarcinoma in columnar-lined oesophagus. In the UK, it is believed that failure to detect intestinal metaplasia at index endoscopy does not imply its absence within the columnarized segment or that the tissue is not at risk of neoplastic transformation. The aim of this study was to investigate the factors predicting the probability of detection of intestinal metaplasia in the columnarized segment.
Material And Methods: Demonstration of intestinal metaplasia was analysed in 3568 biopsies of non-dysplastic columnar-lined oesophagus from 1751 patients from 7 centres in the UK. Development of dysplasia and adenocarcinoma was analysed in 322 patients without intestinal metaplasia and compared with that in 612 patients with intestinal metaplasia.
Results: Intestinal metaplasia was more commonly detected in males than in females (odds ratio 1.244), longer segment length (10.3% increase per centimetre) and increasing number of biopsies taken (24% increase per unit increase). After 5 years of follow-up, 54.8% of patients without intestinal metaplasia at index endoscopy demonstrated intestinal metaplasia, and 90.8% after 10 years. There was no significant difference in the rate of development of dysplasia or adenocarcinoma between patients with or without intestinal metaplasia detection at index endoscopy.
Conclusions: Detection of intestinal metaplasia is subject to significant sampling error. It increases with segment length and number of biopsies taken. In the majority of patients, if sufficient biopsies are taken over time, intestinal metaplasia will be demonstrated. The decision to offer surveillance should not be based upon the presence or absence of intestinal metaplasia at index endoscopy as the risk of dysplasia and adenocarcinoma is similar in both groups.
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http://dx.doi.org/10.1080/00365520701879831 | DOI Listing |
Int J Biol Macromol
January 2025
Department of Gastrosplenic surgery, Harbin Medical University, Harbin 150000, Heilongjiang Province, China. Electronic address:
Gastric cancer is a prevalent gastrointestinal tumor. In the classical cascade of gastric cancer development, the gradual progression from non-atrophic gastritis, atrophic gastritis, intestinal metaplasia, to intraepithelial neoplasia eventually leads to early gastric cancer. We investigated the proteomic characteristics of chronic gastritis (CG), low-grade intraepithelial neoplasia (low-grade LGIN), and early gastric cancer (EGC).
View Article and Find Full Text PDFCancers (Basel)
January 2025
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia.
Background/objectives: Gastric intestinal metaplasia (GIM) is considered an irreversible preneoplastic precursor for gastric adenocarcinoma in adults. However, its significance in children and the long-term outcome remain poorly understood.
Methods: All children diagnosed with GIM between 2000 and 2020 were identified at a large tertiary referral centre.
Nutrients
December 2024
Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO), National Cancer Institute, IRCCS, 33081 Aviano, Italy.
Background/objectives: Gastric cancer (GC) incidence remains high worldwide, and the survival rate is poor. GC develops from atrophic gastritis (AG), associated with () infection, passing through intestinal metaplasia and dysplasia steps. Since eradication does not exclude GC development, further investigations are needed.
View Article and Find Full Text PDFJ Cancer Prev
December 2024
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Serological tests for needs local validation as the diagnostic accuracy may vary depending on the prevalence of . . This study examined the diagnostic performance of two ELISA, GastroPanel (GastroPanel ELISA; Biohit Oyj) and GENEDIA (GENEDIA .
View Article and Find Full Text PDFAm J Gastroenterol
December 2024
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.
Background And Aims: Oral microbiota may contribute to the development of upper gastrointestinal (UGI) disorders. We aimed to study the association between the microbiome of saliva, subgingival and buccal mucosa, and UGI disorders, particularly precancerous lesions. We also aimed to determine which oral site might serve as the most effective biomarker for UGI disorders.
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