Prevalence and correlation of chronic atrophic gastritis, intestinal metaplasia and other precancerous lesions of stomach in Iran: a historical cohort study

Background: Gastric cancer (GC) is known to be the second main cause of cancer deaths all over the world, despite, the incidence and mortality has been declining especially in industrialized countries. Our aim was to evaluate the correlations between chronic atrophic gastritis (CAG) and other precancerous lesions such as intestinal metaplasia (IM) and epithelial dysplasia (ED) with Helicobacter pylori infection (HPI) in one thousand and ninety eight patients who underwent upper gastrointestinal (GI) endoscopy in Iranian population. Methods: Standard upper GI video endoscopy examinations were carried out under sedation with midazolam. The specimens were sent for pathology evaluation. Statistical analyses were performed using IBM SPSS statistics 19. The P values of less than 0.05 were considered statistically significant. Results: HPI prevalence increased in the first 40 years of life and the incidence of gastric atrophy (GA) and IM steadily progress lifetime with an additive rate of increase in the adulthood. A notable increase in IM and dysplasia associated with more sever grade of GA. Conclusions: In this study unlike previous studies who supported the evident role of HPI in the development of gastric precancerous lesions, our study showed HPI does not own a significant direct effect on the incidence of mentioned lesions but CAG alone, was an independent factor for development of IM and ED.