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dc.contributor.authorLee, JWJ
dc.contributor.authorZhu, F
dc.contributor.authorSrivastava, S
dc.contributor.authorTsao, SK
dc.contributor.authorKhor, C
dc.contributor.authorHo, KY
dc.contributor.authorFock, KM
dc.contributor.authorLim, WC
dc.contributor.authorAng, TL
dc.contributor.authorChow, WC
dc.contributor.authorSo, JBY
dc.contributor.authorKoh, CJ
dc.contributor.authorChua, SJ
dc.contributor.authorWong, ASY
dc.contributor.authorRao, J
dc.contributor.authorLim, LG
dc.contributor.authorLing, KL
dc.contributor.authorChia, C-K
dc.contributor.authorOoi, CJ
dc.contributor.authorRajnakova, A
dc.contributor.authorYap, WM
dc.contributor.authorSalto-Tellez, M
dc.contributor.authorHo, B
dc.contributor.authorSoong, R
dc.contributor.authorChia, KS
dc.contributor.authorTeo, YY
dc.contributor.authorMing, T
dc.contributor.authorYeoh, K-G
dc.date.accessioned2021-05-24T08:20:20Z
dc.date.available2021-05-24T08:20:20Z
dc.date.issued2021-05-11
dc.identifier.citationGut, 2021
dc.identifier.issn0017-5749
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/4572
dc.identifier.eissn1468-3288
dc.identifier.eissn1468-3288en_US
dc.identifier.doi10.1136/gutjnl-2021-324057
dc.identifier.doi10.1136/gutjnl-2021-324057en_US
dc.description.abstractObjective To investigate the incidence of gastric cancer (GC) attributed to gastric intestinal metaplasia (IM), and validate the Operative Link on Gastric Intestinal Metaplasia (OLGIM) for targeted endoscopic surveillance in regions with low-intermediate incidence of GC.Methods A prospective, longitudinal and multicentre study was carried out in Singapore. The study participants comprised 2980 patients undergoing screening gastroscopy with standardised gastric mucosal sampling, from January 2004 and December 2010, with scheduled surveillance endoscopies at year 3 and 5. Participants were also matched against the National Registry of Diseases Office for missed diagnoses of early gastric neoplasia (EGN).Results There were 21 participants diagnosed with EGN. IM was a significant risk factor for EGN (adjusted-HR 5.36; 95% CI 1.51 to 19.0; p<0.01). The age-adjusted EGN incidence rates for patients with and without IM were 133.9 and 12.5 per 100 000 person-years. Participants with OLGIM stages III-IV were at greatest risk (adjusted-HR 20.7; 95% CI 5.04 to 85.6; p<0.01). More than half of the EGNs (n=4/7) attributed to baseline OLGIM III-IV developed within 2 years (range: 12.7-44.8 months). Serum trefoil factor 3 distinguishes (Area Under the Receiver Operating Characteristics 0.749) patients with OLGIM III-IV if they are negative for <i>H. pylori</i>. Participants with OLGIM II were also at significant risk of EGN (adjusted-HR 7.34; 95% CI 1.60 to 33.7; p=0.02). A significant smoking history further increases the risk of EGN among patients with OLGIM stages II-IV.Conclusions We suggest a risk-stratified approach and recommend that high-risk patients (OLGIM III-IV) have endoscopic surveillance in 2 years, intermediate-risk patients (OLGIM II) in 5 years.
dc.formatPrint-Electronic
dc.languageeng
dc.language.isoeng
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.titleSeverity of gastric intestinal metaplasia predicts the risk of gastric cancer: a prospective multicentre cohort study (GCEP).
dc.typeJournal Article
dcterms.dateAccepted2021-04-30
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1136/gutjnl-2021-324057
rioxxterms.licenseref.startdate2021-05-11
rioxxterms.licenseref.startdate2021-05-11en_US
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfGut
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Integrated Pathology
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Integrated Pathology
pubs.publication-statusPublished
pubs.embargo.termsNot known
icr.researchteamIntegrated Pathology
icr.researchteamIntegrated Pathologyen_US
dc.contributor.icrauthorSalto-Tellez, Manuelen


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