Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary?
Abstract Background Early detection and appropriate treatment of precancerous, mucosal changes could significantly decrease the prevalence of life-threatening gastric cancer. Biopsy of the normal-appearing mucosa to detect Helicobacter pylori and these conditions is not routinely obtained. This stud...
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BMC
2021-10-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-021-08626-6 |
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| author | Abbas Esmaeilzadeh Ladan Goshayeshi Robert Bergquist Lida Jarahi Alireza Khooei Alireza Fazeli Hooman Mosannen Mozaffari Ali Bahari Mohammad Bagher Oghazian Benyamin Hoseini |
| author_facet | Abbas Esmaeilzadeh Ladan Goshayeshi Robert Bergquist Lida Jarahi Alireza Khooei Alireza Fazeli Hooman Mosannen Mozaffari Ali Bahari Mohammad Bagher Oghazian Benyamin Hoseini |
| author_sort | Abbas Esmaeilzadeh |
| collection | DOAJ |
| description | Abstract Background Early detection and appropriate treatment of precancerous, mucosal changes could significantly decrease the prevalence of life-threatening gastric cancer. Biopsy of the normal-appearing mucosa to detect Helicobacter pylori and these conditions is not routinely obtained. This study assesses the prevalence and characteristics of H. pylori infection and precancerous conditions in a group of patients suffering from chronic dyspepsia who were subjected to gastric endoscopy and biopsy mapping. Methods This cross-sectional study included dyspeptic patients, not previously treated for H. pylori, undergoing esophagogastroduodenoscopy (EGD) with their gastric endoscopic biopsies obtained for examination for evidence of H. pylori infection and precancerous conditions. Demographic and clinical data on the gender, smoking, opium addiction, alcohol consumption, medication with aspirin, corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) and family history of cancer were collected by interviewing the patients and evaluating their health records. The cohort examined consisted of 585 patients with a mean (SD) age of 48.0 (14.46) years, 397 (67.9%) of whom were women. Results H. pylori infection was identified in 469 patients (80.2%) with the highest prevalence (84.2%) in those aged 40–60 years. Opium addiction correlated with a higher a H. pylori infection rate, while alcohol consumption was associated with a lower rate by Odds Ratio 1.98 (95% CI 1.11–3.52) and 0.49 (95% CI 0.26–0.92), respectively. The prevalence of intestinal metaplasia, gastric atrophy and gastric dysplasia was 15.2, 12.6 and 7.9%, respectively. Increased age, positive H. pylori infection, endoscopic abnormal findings and opium addiction showed a statistically significant association with all precancerous conditions, while NSAID consumption was negatively associated with precancerous conditions. For 121 patients (20.7% of all), the EGD examination revealed normal gastric mucosa, however, for more than half (68/121, 56.2%) of these patients, the histological evaluation showed H. pylori infection, and also signs of atrophic mucosa, intestinal metaplasia and dysplasia in 1.7, 4.1 and 1.7%, respectively. Conclusion EGD with gastric biopsy mapping should be performed even in the presence of normal-appearing mucosa, especially in dyspeptic patients older than 40 years with opium addiction in north-eastern Iran. Owing to the high prevalence of precancerous conditions and H. pylori infection among patients with dyspepsia in parts of Iran, large-scale national screening in this country should be beneficial. |
| first_indexed | 2024-12-17T12:00:23Z |
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| id | doaj.art-8e26af2ace1e43179fcd52c14bdd032e |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-17T12:00:23Z |
| publishDate | 2021-10-01 |
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| spelling | doaj.art-8e26af2ace1e43179fcd52c14bdd032e2022-12-21T21:49:52ZengBMCBMC Cancer1471-24072021-10-0121111210.1186/s12885-021-08626-6Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary?Abbas Esmaeilzadeh0Ladan Goshayeshi1Robert Bergquist2Lida Jarahi3Alireza Khooei4Alireza Fazeli5Hooman Mosannen Mozaffari6Ali Bahari7Mohammad Bagher Oghazian8Benyamin Hoseini9Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical SciencesDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical SciencesIngerodCommunity Medicine Department, Faculty of Medicine, Mashhad University of Medical sciencesDepartment of Pathology, Faculty of Medicine, Mashhad University of Medical SciencesCardiology Resident, Faculty of Medicine, Mashhad University of Medical SciencesDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical SciencesDepartment of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical SciencesDepartment of Internal Medicine, Faculty of Medicine, North Khorasan University of Medical SciencesPharmaceutical Research Center, Mashhad University of Medical SciencesAbstract Background Early detection and appropriate treatment of precancerous, mucosal changes could significantly decrease the prevalence of life-threatening gastric cancer. Biopsy of the normal-appearing mucosa to detect Helicobacter pylori and these conditions is not routinely obtained. This study assesses the prevalence and characteristics of H. pylori infection and precancerous conditions in a group of patients suffering from chronic dyspepsia who were subjected to gastric endoscopy and biopsy mapping. Methods This cross-sectional study included dyspeptic patients, not previously treated for H. pylori, undergoing esophagogastroduodenoscopy (EGD) with their gastric endoscopic biopsies obtained for examination for evidence of H. pylori infection and precancerous conditions. Demographic and clinical data on the gender, smoking, opium addiction, alcohol consumption, medication with aspirin, corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) and family history of cancer were collected by interviewing the patients and evaluating their health records. The cohort examined consisted of 585 patients with a mean (SD) age of 48.0 (14.46) years, 397 (67.9%) of whom were women. Results H. pylori infection was identified in 469 patients (80.2%) with the highest prevalence (84.2%) in those aged 40–60 years. Opium addiction correlated with a higher a H. pylori infection rate, while alcohol consumption was associated with a lower rate by Odds Ratio 1.98 (95% CI 1.11–3.52) and 0.49 (95% CI 0.26–0.92), respectively. The prevalence of intestinal metaplasia, gastric atrophy and gastric dysplasia was 15.2, 12.6 and 7.9%, respectively. Increased age, positive H. pylori infection, endoscopic abnormal findings and opium addiction showed a statistically significant association with all precancerous conditions, while NSAID consumption was negatively associated with precancerous conditions. For 121 patients (20.7% of all), the EGD examination revealed normal gastric mucosa, however, for more than half (68/121, 56.2%) of these patients, the histological evaluation showed H. pylori infection, and also signs of atrophic mucosa, intestinal metaplasia and dysplasia in 1.7, 4.1 and 1.7%, respectively. Conclusion EGD with gastric biopsy mapping should be performed even in the presence of normal-appearing mucosa, especially in dyspeptic patients older than 40 years with opium addiction in north-eastern Iran. Owing to the high prevalence of precancerous conditions and H. pylori infection among patients with dyspepsia in parts of Iran, large-scale national screening in this country should be beneficial.https://doi.org/10.1186/s12885-021-08626-6Gastric biopsyHistopathologyHelicobacter pyloriPrecancerous conditionsAddictionIran |
| spellingShingle | Abbas Esmaeilzadeh Ladan Goshayeshi Robert Bergquist Lida Jarahi Alireza Khooei Alireza Fazeli Hooman Mosannen Mozaffari Ali Bahari Mohammad Bagher Oghazian Benyamin Hoseini Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary? BMC Cancer Gastric biopsy Histopathology Helicobacter pylori Precancerous conditions Addiction Iran |
| title | Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary? |
| title_full | Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary? |
| title_fullStr | Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary? |
| title_full_unstemmed | Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary? |
| title_short | Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary? |
| title_sort | characteristics of gastric precancerous conditions and helicobacter pylori infection among dyspeptic patients in north eastern iran is endoscopic biopsy and histopathological assessment necessary |
| topic | Gastric biopsy Histopathology Helicobacter pylori Precancerous conditions Addiction Iran |
| url | https://doi.org/10.1186/s12885-021-08626-6 |
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