Gastric precancerous conditions in patients with chronic dyspepsia

Introduction

Gastric cancer (GC) is one of the most lethal malignancies worldwide, though a decrease in incidence. Helicobacter pylori is positively associated with gastric precancerous conditions. Detection of these conditions, namely atrophic gastritis (AG) and intestinal metaplasia (IM), and their association with H pylori infection is important for further detection and reduction of overall cancer incidence.

Aim

To detect the prevalence of H pylori infection and gastric precancerous conditions in patients with chronic dyspepsia by High Definition White Light Endoscopy (HD-WLE) and Narrow Band Imaging with Magnifying Endoscopy (NBI-ME).

Methods

This was a hospital-based descriptive study including chronic dyspeptic patients aged over 50 years. H pylori infection was diagnosed by a rapid urease test. AG and IM were detected by endoscopy (HD-WLE and NBI-ME) and confirmed by histology. Detection rates of each method were compared.

Results

Totally 143 patients (55 males/88 females) with a mean age of 64.57 ± 9.957 years were included. H pylori infection rate was 53.84% (n = 77). Twenty-two patients with AG (44.9% of patients with atrophy) and 37.84% (14/37) of patients with IM have H pylori infection. There was a statistically significant difference in detection rates between HD-WLE and NBI-ME for IM (P=0.001) but not for AG (P=0.250).

Conclusion

H pylori infection is still high in Myanmar. There were significant associations between H pylori and gastric precancerous lesions. Detection of atrophic gastritis and intestinal metaplasia by routine usage of NBI-ME along with test and treat H pylori infection are the strategies to reduce the incidence of gastric cancer.