Chronic atrophic gastritis (CAG) with intestinal metaplasia (IM) is a feature of the multistep process leading to the intestinal gastric cancer. It has recently been suggested that the eradication of the Helicobacter Pylori (Hp) infection may be associated with regression of IM. The aim of the study was to assess the possible regression of type I and type III IM after Hp eradication in a prospective randomized study. The patients admitted at the study were randomly allocated to eradication treatment (Ome 40 mg + Amox 3 gr + Metr 1 gr/die for 12 days) or no treatment: with a different schedule for group 1 and 2. Actually 100 patients are included in the protocol. The present report considers 26 patients with CAG and type IIM (Group 1) and 18 CAG and type III IM (Group 2), included in the study, followed to 3, 6, 12, 24 months in our Institute with endoscopy and histology. Mean age was 48 years (range 25-67) in Group 1 and 56 (range 35-65) in Group 2. All patients considered, underwent a 24-28 months' follow-up with at least three endoscopic controls and 8-10 biopsies in the whole gastric mucosa. 13 subjects in Group 1 and 10 in Group 2 received Hp eradication treatment. At first endoscopie control all treated patients resulted Hp negative. Group 1 treated: only one case was found free of IM at the follow-up of 24 months; 2 cases presented type II IM, one remaining Hp negative while the second became Hp positive at the last control. One case showed mild dysplasia after 20 months, Hp negative, and presented early gastric cancer and became Hp positive 6 months later. The remaining 9 cases did not change type of IM and persisted to be Hp negative. Group 1 not treated: 1 subject presented type II IM. Group 2 treated: regression of gastric lesion was observed in 2 patients, one presenting gastric mucosa without IM at lasi control, and the other with type II IM. Group 2 not treated: 1 subject was found with moderate dysplasia, the remainder being unchanged. Regression of precancerous gastric lesions was observed in the treated group only in 3 patients; though some cases presented also a progression of IM even with a case of early gastric cancer.
|Publication status||Published - 1997|
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