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Endoscopic Surveillance of Gastric Intestinal Metaplasia: A Retrospective Cohort Study.
Yoon, Ji Yoon; Katcher, Erik; Cohen, Ella; Ward, Stephen C; Rouphael, Carol; Itzkowitz, Steven H; Wang, Christina P; Kim, Michelle K; Shah, Shailja C.
Afiliación
  • Yoon JY; Departments of Gastroenterology.
  • Katcher E; Sackler School of Medicine at Tel Aviv University, Tel Aviv, Israel.
  • Cohen E; Medicine.
  • Ward SC; Pathology, Molecular, and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
  • Rouphael C; Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, Cleveland, OH.
  • Itzkowitz SH; Departments of Gastroenterology.
  • Wang CP; Departments of Gastroenterology.
  • Kim MK; Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, Cleveland, OH.
  • Shah SC; Division of Gastroenterology, University of California San Diego.
J Clin Gastroenterol ; 2024 Jul 17.
Article en En | MEDLINE | ID: mdl-39042489
ABSTRACT

BACKGROUND:

Gastric intestinal metaplasia (GIM) is a precancerous condition. Limited data exist on real-world clinical practice relative to guidelines.

AIM:

The aim of this study was to evaluate adherence to GIM risk stratification and identify factors associated with follow-up endoscopy. MATERIALS AND

METHODS:

We conducted manual chart review of patients with histologically confirmed GIM at an urban, tertiary medical center were identified retrospectively and details of their demographics, Helicobacter pylori, biopsy protocol, endoscopic/histologic findings, and postendoscopy follow-up were recorded. Multivariable logistic regression was used to identify factors independently associated with follow-up endoscopy.

RESULTS:

Among 253 patients, 59% were female, 37% non-Hispanic White (NHW), 26% Hispanic, 16% non-Hispanic Black (NHB). The median age at index endoscopy was 63.4 years (IQR 55.9 to 70.0), with median follow-up of 65.1 months (IQR 44.0 to 72.3). H. pylori was detected in 21.6% patients at index EGD. GIM extent and subtype data were frequently missing (22.9% and 32.8%, respectively). Based on available data, 26% had corpus-extended GIM and 28% had incomplete/mixed-type GIM. Compared with NHW, Hispanic patients had higher odds of follow-up EGD (OR=2.48, 95% CI 1.23-5.01), while NHB patients had 59% lower odds of follow-up EGD (OR=0.41, 95% CI 0.18-0.96). Corpus-extended GIM versus limited GIM (OR=2.27, 95% CI 1.13-4.59) was associated with follow-up EGD, but GIM subtype and family history of gastric cancer were not.

CONCLUSIONS:

We observed suboptimal risk stratification among patients with GIM and notable race and ethnic disparities with respect to endoscopic surveillance. Targeted interventions are needed to improve practice patterns and mitigate observed disparities.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Gastroenterol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Gastroenterol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos