Predictive Factors for Improvement of Atrophic Gastritis and Intestinal Metaplasia: A Long-term Prospective Clinical Study
Korean J Helicobacter Up Gastrointest Res 2018;18(3):186-197
Published online September 10, 2018
© 2018 Korean College of Helicobacter and Upper Gastrointestinal Research.

Young-Jae Hwang1, Nayoung Kim1,2, Chang Yong Yun1, Min Gu Kwon1, Sung Min Baek1, Yeong Jae Kwon1, Hye Seung Lee3, Jae Bong Lee4, Yoon Jin Choi1, Hyuk Yoon1, Cheol Min Shin1, Young Soo Park1, Dong Ho Lee1,2

Department of Internal Medicine, Seoul National University Bundang Hospital1, Seongnam, Department of Internal Medicine and Institute of Liver Research, Seoul National University College of Medicine2, Seoul, Department of Pathology3 and Division of Statistics in Medical Research Collaborating Center4, Seoul National University Bundang Hospital, Seongnam, Korea
Correspondence to: Nayoung Kim
Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea
Tel: +82-31-787-7008, Fax: +82-31-787-4051, E-mail: nayoungkim49@empas.com
ORCID: https://orcid.org/0000-0002-9397-0406
Received June 1, 2018; Revised July 21, 2018; Accepted July 22, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: To investigate the predictive factors for improvement of atrophic gastritis (AG) and intestinal metaplasia (IM).
Materials and Methods: A total of 778 subjects were prospectively enrolled and followed up for 10 years. Histological analysis of AG and IM was performed by using the updated Sydney system. To find the predictive factors for reversibility of AG and IM, 24 factors including genetic polymorphisms and bacterial and environmental factors were analyzed.
Results: In all subjects, the predictive factor by multivariate analysis for improvement of both antral and corpus AG was successful eradication. The predictive factors for improvement of antral IM were age and successful eradication. The predictive factor for improvement of corpus IM was successful eradication. In patients with Helicobacter pylori infection, age and cagA were predictive factors for improvement of AG and IM. In patients with H. pylori eradication, monthly income and cagA were predictive factors for improvement of AG and IM.
Conclusions: H. pylori eradication is an important predictive factor of regression of AG and IM and would be beneficial for the prevention of intestinal-type gastric cancer. Young age, high income, and cagA are additional predictive factors for improving AG and IM status. Thus, various factors affect the improvement of AG and IM.
Keywords : Atrophic gastritis; Helicobacter pylori; Intestinal metaplasia; Therapeutics


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