Gastric Precancerous Lesions: Clinical and Endoscopic Predictors

Aims Atrophic gastritis, gastric intestinal metaplasia and dysplasia are well defined intermediate precancerous lesions (PCL) in the gastric cancer cascade. The diagnosis of PCL may be suspected based on endoscopic findings, but is established by histology. Unfortunately, estimates of the global prevalence of these lesions vary widely and predictors of their diagnosis are ill defined. We aimed to evaluate the prevalence of gastric PCL in our practice and to identify predictors for its diagnosis.

Methods We reviewed electronic reports of patients referred for gastroscopy procedures over a 5-year period and included patients whose producers involved the performance of biopsy from gastric mucosa. We investigated demographic, clinical and endoscopic findings to identify possible association with a histologic detection of gastric PCL and performed multivariate analysis to identify predictors of its diagnosis.

Results A total of 4930 patients with full endoscopic and histologic data were included for the final analysis. Of these, 806 (16.3 %) patients had a histologic diagnosis of gastric PCL. Clinical variables including male sex (51.4 % vs. 45.7 %; P = 0.003), age over 60 (69.8 % vs. 45.2 %; P<0.001), and anemia indication for gastroscopy (17.6 % vs. 14.8 %; P = 0.04) were significantly associated with gastric PCL diagnosis. Similarly, endoscopic findings of Barret’s esophagus (2.6 % vs. 1.3 %; P = 0.006), Atrophic gastritis according to endoscopist’s discernment (12.9 % vs. 3.5 %; P < 0.01) and pan-gastritis (22.5 % vs. 14.7 %; P=0.02) were significantly associated with gastric PCL. In multivariate analysis, age>60 (HR 2.51, 95 % CI 2.12-2.96), male sex (HR 1.235, 95 % CI 1.05-1.44), pan-gastritis (HR 1.284, 95 % CI 1.04-1.57), and atrophic gastritis (HR 4, 95 % CI 3.07-5.21) were independent predictors for PCL diagnosis.

Conclusions We outlined clinical and endoscopic predictors that may aid in the endoscopist decision to perform gastric biopsy to identify gastric PCL.

Citation: Abu Baker F, Davidov Y, Mari A et al. OP155 GASTRIC PRECANCEROUS LESIONS: CLINICAL AND ENDOSCOPIC PREDICTORS. Endoscopy 2021; 53: S63.

Publication History

Article published online:
19 March 2021