Brief Article
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World J Gastroenterol. Apr 7, 2013; 19(13): 2060-2064
Published online Apr 7, 2013. doi: 10.3748/wjg.v19.i13.2060
Atrophic gastritis: Risk factor for esophageal squamous cell carcinoma in a Latin-American population
Emiliano de Carvalho Almodova, Walmar Kerche de Oliveira, Lucas Faria Abrahão Machado, Juliana Rigotto Grejo, Thiago Rabelo da Cunha, Wagner Colaiacovo, Erika Veruska Paiva Ortolan
Emiliano de Carvalho Almodova, Thiago Rabelo da Cunha, Wagner Colaiacovo, Endoscopy Department, Cancer Hospital of Barretos, Barretos, São Paulo 147830-066, Brazil
Emiliano de Carvalho Almodova, Surgery Post Graduate Course, Botucatu Medical School, State of Sao Paulo University, Botucatu, São Paulo 18600-000, Brazil
Walmar Kerche de Oliveira, Erika Veruska Paiva Ortolan, Surgery and Orthopedics Department, Botucatu Medical School, State of Sao Paulo University, Botucatu, São Paulo 18600-000, Brazil
Lucas Faria Abrahão Machado, Pathology Department, Cancer Hospital of Barretos, Barretos, São Paulo 147830-066, Brazil
Juliana Rigotto Grejo, Endoscopy Department, Botucatu Medical School, State of Sao Paulo University, Botucatu, São Paulo 18600-000, Brazil
Author contributions: Almodova EC, Oliveira WK and Ortolan EVP designed the research; Almodova EC, Grejo JR and Cunha TR performed the research; Almodova EC, Machado LFA, Colaiacovo W and Ortolan EVP analyzed the data; Almodova EC and Ortolan EVP wrote the paper; Colaiacovo W and Ortolan EVP revised the final version.
Correspondence to: Erika Veruska Paiva Ortolan, PhD, MD, Assistant Professor, Surgery and Orthopedics Department, Botucatu Medical School, State of Sao Paulo University, Botucatu, São Paulo 18600-000, Brazil. epaiva@fmb.unesp.br
Telephone: +55-14-38116269 Fax: +55-14-38157428
Received: November 1, 2012
Revised: January 4, 2013
Accepted: January 23, 2013
Published online: April 7, 2013
Processing time: 159 Days and 7.2 Hours
Abstract

AIM: To study the association between atrophic gastritis (AG) and esophageal squamous cell carcinoma (ESCC) in a Latin-America population.

METHODS: A case-control study was performed at two reference Brazilian hospitals including patients diagnosed with advanced ESCC and dyspeptic patients who had been subjected to upper gastrointestinal endoscopy, with biopsies of the gastric antrum and body. All cases with ESCC were reviewed by a single pathologist, who applied standard criteria for the diagnosis of mucosal atrophy, intestinal metaplasia, and dysplasia, all classified as AG. The data on the patients’ age, sex, smoking status, and alcohol consumption were collected from clinical records, and any missing information was completed by telephone interview. The association between AG and ESCC was assessed by means of univariate and multiple conditional logistic regressions.

RESULTS: Most patients were male, and the median age was 59 years (range: 37-79 years) in both the ESCC and control groups. Univariate analysis showed that an intake of ethanol greater than 32 g/d was an independent risk factor that increased the odds of ESCC 7.57 times (P = 0.014); upon multiple analysis, alcohol intake of ethanol greater than 32 g/d exhibited a risk of 4.54 (P = 0.081), as adjusted for AG and smoking. Smoking was shown to be an independent risk factor that increased the odds of ESCC 14.55 times (P = 0.011) for individuals who smoked 0 to 51 packs/year and 21.40 times (P = 0.006) for those who smoked more than 51 packs/year. Upon multiple analyses, those who smoked up to 51 packs/year exhibited a risk of 7.85 (P = 0.058), and those who smoked more than 51 packs/ year had a risk 11.57 times higher (P = 0.04), as adjusted for AG and alcohol consumption. AG proved to be a risk factor that increased the odds of ESCC 5.33 times (95%CI: 1.55-18.30, P = 0.008) according to the results of univariate conditional logistic regression.

CONCLUSION: There was an association by univariate conditional logistic regression between AG and ECSS in this sample of Latin-American population.

Keywords: Atrophic gastritis; Esophagus; Squamous cell carcinoma; Risk factor; Alcohol; Tobacco