Gastric Intestinal Metaplasia Is the Most Common Histopathological Phenotype among Endoscopically Diagnosed Atrophic Gastritis Patients in North-East China

Background: Gastric cancer and gastric precancerous lesions are highly prevalent in China. However, prevalence of the different precancerous lesions has not been reported from the north-east region of China. Detection of precancerous gastric lesions at an early stage complemented with a follow-up strategy for high risk groups would probably aid in declining the mortality rate in patients with gastric cancer. Helicobacter pylori infection, salt intake, smoking, alcohol, family history of gastric cancer, atrophic gastritis and intestinal metaplasia are established risk factors of gastric cancer. The aim of this study was to evaluate the frequency of various histopathological phenotypes among atrophic gastritis patients in this region and to report if gender and increasing age carry risk in the development of these lesions. Methods: This retrospective study was conducted on 518 patients with endoscopic diagnosis of atrophic gastritis. Using the patient number in database, histopathological diagnosis of the biopsy specimen of all patients was recorded. All biopsy specimens were assessed for the presence of inflammation, atrophic gastritis, metaplasia and/or dysplasia. Results: Intestinal metaplasia was observed in 67.38% of patients. Dysplasia and atrophy were present in 9.46% and 3.67% patients, respectively. Gender and increasing age were not found to be risk factors for intestinal metaplasia, dysplasia and atrophic gastritis (p-values 0.08, 0.43, 0.297 and 0.98, 0.20, 0.54; respectively). 19.49% subjects showed inflammatory activity which was significantly associated with female gender (P = 0.0008). Conclusion: Intestinal metaplasia was the most histopathological phenotype among endoscopically diagnosed atrophic gastritis patients. Large-population based on prospective studies should be designed to determine prevalence of precancerous lesions and the risk factors involved in the progression of these lesions in our region.