The Incidence of Gastric Adenocarcinoma among Patients with Gastric Intestinal Metaplasia A Long-term Cohort Study

doi:10.1097/MCG.0000000000000406

中山醫學大學機構典藏 CSMUIR > 醫學院 > 醫學研究所 > 期刊論文 > Item 310902500/15616

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题名:	The Incidence of Gastric Adenocarcinoma among Patients with Gastric Intestinal Metaplasia A Long-term Cohort Study
作者:	Lee, T.Y. Wang, R.C. Lee, Y.C. Lin, J.T.ij, Ho, H.J. Hsieh, M.C. Wu, C.-Y.
贡献者:	醫學研究所
关键词:	gastric cancer;precancerous;premalignant;surveillance
日期:	2016-08-01
上传时间:	2016-08-04T03:57:12Z (UTC)
出版者:	Lippincott Williams and Wilkins
ISSN:	01920790
摘要:	Background and Aims: Gastric intestinal metaplasia (IM) has been known as a premalignant condition, but estimates of its cancer risk vary widely. We aimed to analyze cancer risk of gastric IM by a long-term cohort study. Methods: We conducted a hospital-based study that included all patients with gastric IM between 1992 and 2010, and the development of gastric adenocarcinoma was evaluated until July 2011. Patients developing gastric cancer r180 days after the index diagnosis of IM were excluded. The incidence rate, the cumulative incidence, and the standardized incidence ratio (SIR) of gastric cancer were determined, and hazard ratios (HRs) of risk factors were calculated. Results: We identified 7059 patients with a median follow-up durationof 5.1 years, and 81 patients developed gastric adenocarcinoma duringthe study period. The 5-, 10-, and 15-year cumulative incidences of gastric cancer were 0.9% [95% confidence interval (CI), 0.6-1.1), 2.0% (95% CI, 1.5-2.6), and 3.0% (95% CI, 2.0-4.0), respectively. On multivariate analysis, older age (eg, 75 y and above; HR=7.4; 95% CI, 2.8-19.6), low-grade dysplasia (HR=4.0; 95% CI, 2.1-7.9), and high-grade dysplasia (HR=18.8; 95% CI, 9.0-39.5) were independent risk factors. As compared with the risk in the general population, the SIR of gastric cancer among patients with gastric IMwas 2.5 (95%CI, 2.0-3.1). However, the SIR was only 2.0 (95% CI, 1.5-2.6) in the nondysplasia subgroup, but was up to 35.2 (95% CI, 15.2-69.4) in the high-grade dysplasia subgroup. Conclusions: Gastric IM is an important risk factor for gastric cancer, but surveillance should be arranged only for those at an especially high risk. © Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved.
URI:	https://ir.csmu.edu.tw:8080/ir/handle/310902500/15616 http://dx.doi.org/10.1097/MCG.0000000000000406
關聯:	Journal of Clinical Gastroenterology Volume 50, Issue 7, 1 August 2016, Pages 532-537
显示于类别:	[醫學研究所] 期刊論文

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