ENDOSCOPIC SURVEILLANCE IN AUTOIMMUNE GASTRITIS: 3-YEAR FOLLOW-UP SEEMS APPROPRIATE

Aims Autoimmune atrophic gastritis (AAG) is an atrophic gastritis restricted to the corpus and it represents a risk factor for the development of gastric cancer. European guidelines suggest a follow-up between 3 and 5 years for patients harbouring this condition. We aimed to investigate the occurrence of gastric neoplastic lesions in AIG patients at a 3-year follow-up.

Methods A longitudinal cohort study of 122 AAG patients was performed. Endoscopic surveillance was performed 3 years after diagnosis with the use of electronic chromoendoscopy and target biopsies were performed when intestinal metaplasia was recognized, otherwise, biopsies were performed according to the updated Sydney system.

Results Females were 74.6% and the median age was 65(35-87) years. At follow-up 11 lesions were found: 6(4.9%) type-1 neuroendocrine neoplasms, 5(4.1%) epithelial lesions of those 2(1.6%) were low-grade dysplastic lesions and 3(2.5%) were intestinal-type gastric cancer. Two(18.2%) patients were OLGA I and 9(81.8%) were OLGA II. Only one(9.1%) patient with type-I neuroendocrine neoplasm had first-degree familiarity for gastric cancer, whilst none of the patients with gastric cancer or epithelial dysplastic lesions. All the lesions were endoscopically treated by endoscopic mucosal resection or endoscopic submucosal dissection, except two gastric cancers that required surgery. All the patients are alive and the treatment was curative.

Conclusions AAG is a high-risk condition for the development of gastric lesions as 11 lesions were found at 3-year-follow-up suggesting this time interval seems appropriate and safe. The appropriateness and safety of a longer time interval for endoscopic surveillance in patients with AAG need clarification.

Publication History

Article published online:
14 April 2022