Outcome of Intestinal Metaplasia in Gastric Biopsy of Patients with Dyspepsia in Guilan Province, North Iran


Background: It is generally accepted that gastric carcinomas are preceded by a sequential multistage processthat includes chronic gastritis, gastric atrophy, usually with intestinal metaplasia (IM), and dysplasia. This seriesof changes in gastric carcinogenesis is often initiated by Helicobacter pylori (H pylori) infection. The aim of thepresent study was determination of gastric histopathologic changes in IM patients after at least one year in Guilanprovince, Iran. Materials and
Methods: This case-series study was conducted in Guilan Gastrointestinal and LiverDisease Research Center (GLDRC) during 2010 to 2011. Gastric biopsy was performed for all 71 known cases ofIM and precanceric lesions including gastric atrophy, IM, dysplasia and H pylori infection were determined afterat least one year.
Results: Of the total of 71 patients with established IM who were enrolled, 50 had complete-typeIM and 21 had incomplete-type IM. Fifty two people had H pylori infection. H pylori eradication was achievedin 39 patients (75%). Secondary pathology findings of patients with IM were complete metaplasia (39.4%),incomplete metaplasia (32.4%), dysplasia (23.9%) and other precanceric lesions (4.2%). Dysplasia (20%vs 33%)occurred in patients who had complete and incomplete IM at baseline respectively (p>0.05). Age, gender, familyhistory of gastric cancer(GC); smoking habits and NSAIDs use were not associated with gastric premalignantlesions in initial and secondary pathologies (p>0.05). The difference became statistically significant between Hpylori infection in patients with more than 3 years diagnostic intervals (p<0.05). Statistical difference betweeneradicators and non-eradicators was not significant.
Conclusions: We found that incomplete IM increased therisk of subsequent dysplasia in this study.