作者
Jonathan Wei Jie Lee,Feng Zhu,Supriya Srivastava,Stephen Tsao,Christopher Khor,Khek Yu Ho,Kwong Ming Fock,Wee Chian Lim,Tiing Leong Ang,Wan Cheng Chow,Jimmy Bok Yan So,Calvin Jianyi Koh,Shijia Joy Chua,Andrew Siang Yih Wong,Jaideepraj Rao,Lee Guan Lim,Khoon Lin Ling,Chung-King Chia,Choon Jin Ooi,Andrea Rajnakova,Wai Ming Yap,Manuel Salto-Tellez,Bow Ho,Richie Soong,Kee Seng Chia,Yik Ying Teo,Ming Teh,Khay Guan Yeoh
摘要
Objective 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 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.