THE DEGREE OF ENDOSCOPICALLY EVALUATED MUCOSAL ATROPHY AND GASTRIC CANCER RISK

Aims:

To determine the risk of gastric cancer in western patients with various degree of endoscopically evaluated mucosal atrophy.

Methods:

Data from 2 885 patients were retrospectively analyzed. The degree of mucosal atrophy was classified according to Kimura-Takemoto classification system. We analyzed the frequency of gastric cancer detection in patients with various degree of mucosal atrophy.

Results:

Among 2 885 patients 641 had no atrophy, 494 – C1, 515 – C2, 408 – C3, 241 – O1, 285 – O2, 301 – O3. Gastric cancer was detected in 68 patients (2.3%) including 8 cases of synchronous multiple tumors (totally 83 lesions; 16 – diffuse type and 67 – intestinal type). Patients with diffuse type cancer were younger than those with intestinal type (48.9 ± 3.5 vs. 67.5 ± 1.1; p < 0.0001). The relation between the degree of mucosal atrophy and frequency of gastric cancer detection was as following: 0 degree – 6 cases (0.9%) of cancer; C1 – 1 (0.2%); C2 – 3 (0.6%); C3 – 4 (0.9%); O1 – 10 (4.1%); O2 – 13 (4.6%); O3 – 31 (10.2%). The cancer risk was significantly higher with opened type atrophy than with no or closed type (< 0.00001). Intestinal type of cancer was more common for patients with O1 – O3 atrophy and diffuse type – for patients with 0 and C1 -C3 atrophy (< 0.00001).

Conclusions:

The degree of endoscopically evaluated mucosal atrophy can be used to predict gastric cancer risk and to select the group patients who need endoscopic surveillance.