The following is a summary of “Incidence and Predictors of Gastric Neoplastic Lesions in Corpus-Restricted Atrophic Gastritis: A Single-Center Cohort Study,” published in the December 2023 issue of Gastroenterology by Dilaghi, et al.

Corpus-restricted atrophic gastritis is a chronic inflammatory disorder associated with the potential development of type 1 neuroendocrine tumors (T1gNET), intraepithelial neoplasia (IEN), and gastric cancer (GC). For a study, researchers sought to evaluate the occurrence and predictors of gastric neoplastic lesions in patients with corpus-restricted atrophic gastritis during long-term follow-up.

The study involved a prospective single-center cohort of patients with corpus-restricted atrophic gastritis who followed endoscopic-histological surveillance. Scheduled follow-up gastroscopies adhered to the guidelines for managing epithelial precancerous conditions and stomach lesions. Unscheduled gastroscopies were performed in case of new or worsening symptoms. Cox regression analyses and Kaplan-Meier survival curves were employed.

The cohort comprised 275 patients with corpus-restricted atrophic gastritis (72.0% female, median age 61 [23–84] years). At a median follow-up of 5 (1–17) years, the annual incidence rate per person-year was 0.5%, 0.6%, 2.8%, and 3.9% for GC/high-grade IEN, low-grade IEN, T1gNET, and all gastric neoplastic lesions, respectively. All patients exhibited baseline operative link for gastritis assessment (OLGA)-2, except for 2 low-grade (LG) IEN patients and 1 T1gNET patient with OLGA-1. Age over 60 years (hazard ratio [HR] 4.7), intestinal metaplasia without pseudopyloric metaplasia (HR 4.3), and pernicious anemia (HR 4.3) were associated with a higher risk of GC/HG-IEN or LG-IEN development and a shorter mean survival time for progression (13.4, 13.2, and 11.1, respectively, vs 14.7 years, P = 0.01). Pernicious anemia was an independent risk factor for T1gNET (HR 2.2) and was associated with a shorter mean survival time for progression (11.7 vs 13.6 years, P = 0.04) as well as severe corpus atrophy (12.8 vs 13.6 years, P = 0.03).

Patients with corpus-restricted atrophic gastritis faced an increased risk of GC and T1gNET despite having low-risk OLGA scores. Those aged over 60 years with corpus intestinal metaplasia or pernicious anemia appeared to present a high-risk scenario.

Source: journals.lww.com/ajg/abstract/2023/12000/incidence_and_predictors_of_gastric_neoplastic.18.aspx