Follow-up results in patients with gastric intestinal metaplasia in our clinic

Precancerous stomach lesions are the most frequently blamed factors in gastric cancer etiology. The chain of events in intestinal-type gastric carcinogenesis are considered to be in the form of chronic gastritis, atrophy, intestinal metaplasia (İM), dysplasia and carcinoma. Early diagnosis and treatment of precursor lesions and gastric cancer are possible with the identification and follow-up of patients with such premalignant lesions. We aimed to determine the following results of intestinal metaplasia in our clinic. 468 patients aged between 18-79 years who applied to the Gastroenterology Department of Karadeniz Technical University between 2004 and 2013 and who were undergone gastroscopy with any reason and diagnosed with gastrointestinal metaplasia by pathological examination were evaluated . 114 patients, 58 female and 56 male, who had control gastroscopy and biopsy results were met inclusion criteria in the study. The results of these cases were evaluated retrospectively. The age, gender and pathology results of the patients were evaluated in terms of IM type, IM localization, pathology accompanying IM, presence of helicobacter pylori (Hp) infection and atrophy. In conclusion, one patient with gastric ulcer who had focal IM, had adenocarcinoma within 1 year and one patient developed dysplasia after 27 months. Neither dysplasia nor carcinoma were seen in other patients. There was no significant relationship between IM type, IM localization and pathology accompanying IM; and presence of Hp, age and gender. When control endoscopy of the group with the progression of IM type and IM localization was examined in terms of presence of atrophy, it was seen that patients in this group had more atrophy . IM was most commonly found in antrum. It was seen that IM was common in antrum and corpus in the first endoscopy of the patient who was diagnosed with carcinoma in the control endoscopy, and that IM was found in antrum in the first endoscopy of the patient who was diagnosed with dysplasia in the control endoscopy. No statistically significant difference was found between patients who were applied control endoscopy after 12 months, 13-24 months and 24 months when compared in terms of IM type and pathology accompanying IM, however, there was a significant difference when examined in terms of changes in IM localization. Progression in IM localization was found to be detected more in control endoscopies after 13-24 months. Although the endoscopic appearance was normal, the presence of IM was confirmed in the biopsy specimens taken from 2 patients. In this study, it was observed that 75% of 468 patients diagnosed with IM in our clinic were out of follow-ups and that the patients were followed-up inadequately. This situation can be considered to be caused by potential lack of communication between the patient and the physician and by insufficient informing of the patient about IM. Although the follow-up periods of the patients diagnosed with diffuse IM and atrophy were insufficient, it was thought that patients should be periodically followed-up in terms of risk of cancer.