Gastric dysplasia identified in random gastric biopsies: the influence of helicobacter pylori infection and alcohol consumption in the presence of a lesion

Aims To evaluate factors associated with the presence of an endoscopically visible lesion during follow-up in patients with histologic diagnosis of gastric dysplasia in random biopsies.

Methods Retrospective, cohort study including patients who underwent esophagogastroduodenoscopy (EGD) after the histologic diagnosis of gastric dysplasia in random biopsies, from April 2018 until December 2021. An index endoscopic evaluation was performed immediately with CE-NBI (HD-index EGD). If no lesion, follow-up EGD was conducted within 6 months if high grade dysplasia (HGD) or 12 months if low grade (LGD) or indefinite for dysplasia (IFD).

Results Totally, 96 patients were included, most had LGD (87.4%). Five patients had an endoscopically visible lesion on HD-index (5.2%) and 10 on follow-up EGD (10.4%); 80% in the antrum. Patients with previous Helicobacter pylori infection and with a regular alcohol consumption (≥25grams daily) were 8 and 4 times more likely to have an endoscopically visible lesion on follow-up EGD (p=0.012 and p=0.047), respectively. The location of biopsies and grade of dysplasia were not associated with lesions during follow-up. Both factors were statistically significant predictors of the presence of gastric lesion on follow-up EGD in binary logistic regression (OR 9.284, p=0.009 and OR 5.025, p=0.033, respectively).

Conclusions Only a minority of patients with the histologic diagnosis of gastric dysplasia in random biopsies had an endoscopically visible lesion during follow-up. However, surveillance of these patients is essential since most lesions were identified in the follow-up EGD. Previous Helicobacter pylori infection and regular alcohol consumption were significant predictors of the presence of gastric lesion on follow-up EGD.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publikationsverlauf

Artikel online veröffentlicht:
14. April 2023