Risk factors for intestinal metaplasia in concomitant gastric and duodenal ulcer disease

Hong,Jun‑Bo; Xia,Liang; Zuo,Wei; Wang,An‑Jiang; Xu,Shan; Xiong,Hui‑Fang; Chen,You‑Xiang; Zhu,Xuan; Lu,Nong‑Hua

doi:10.3892/etm.2014.1507

Risk factors for intestinal metaplasia in concomitant gastric and duodenal ulcer disease

Authors:
- Jun‑Bo Hong
- Liang Xia
- Wei Zuo
- An‑Jiang Wang
- Shan Xu
- Hui‑Fang Xiong
- You‑Xiang Chen
- Xuan Zhu
- Nong‑Hua Lu
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Affiliations: Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China, Department of Respiratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China, Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
Published online on: January 28, 2014 https://doi.org/10.3892/etm.2014.1507
Pages: 929-934

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Abstract

The aim of this study was to estimate the prevalence and risk factors of intestinal metaplasia (IM) in concomitant gastric and duodenal ulcer (CGDU) disease by retrospectively reviewing consecutive patients who had undergone esophagogastroduodenal endoscopy. Patients who received the endoscopic diagnosis of CGDU disease were selected for analysis and the recorded demographic, endoscopic, clinical and outcome data, including data on the development of IM, were extracted. Associations of the various parameters with IM were estimated by logistic regression analysis and described by the odds ratio (OR) with a 95% confidence interval (CI). Among the total 204,073 consecutive patients screened, 2,397 (1.2%) were diagnosed with CGDU disease. Following application of the exclusion criteria, a total of 2,149 cases were included in the study. The IM prevalence was 8.4%, represented by 153 mild cases, 26 moderate cases and one severe case. Multivariate analysis identified age ≥50 years (OR=2.606, 95% CI=1.889‑3.597, χ2=34.000, P<0.001), ulcer at the gastric incisura (OR=2.644, 95% CI=1.926‑3.630, χ2=36.142, P<0.001) and Helicobacter pylori (H. pylori) infection (OR=2.338, 95% CI=1.573‑3.474, χ2=17.648, P<0.001) as independent risk factors for the development of IM. In addition, the moderate and severe IM grades were more frequently detected in males than in females (18.8% vs. 5.8%; OR=3.769, 95% CI=1.083‑13.121, χ2=4.887, P=0.036). IM in patients with CGDU disease is not uncommon. CGDU patients with ongoing H. pylori infection, gastric incisura involvement, older age and/or male gender may be at a higher risk of IM.

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