Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10472
Peer-review started: March 27, 2021
First decision: August 18, 2021
Revised: August 31, 2021
Accepted: October 24, 2021
Article in press: October 24, 2021
Published online: December 6, 2021
A large number of intestinal metaplasia (IM) patients need to be effectively treated, which can successfully reduce the risk of gastric cancer (GC). Some medicines have showed the potential to reverse the IM lesion. It would help doctors in clinical practice and refute the concept that IM could not be reversed.
Lamb’s tripe extract and vitamin B12 capsule (LTEVB12) and celecoxib have been proved to reverse IM in past studies. But the IM regression effect of LTEVB12 and celecoxib still have to be evaluated thoroughly by operative link on gastritis assessment (OLGA) and operative link on the gastric intestinal metaplasia assessment (OLGIM) stages. What’s more, the combination of these two kinds of drugs may enhance the effect of IM regression.
This study aimed to validate the efficacy of LTEVB12 initial therapy and celecoxib rescue therapy on IM.
This study was a retrospective cohort study. A total of 255 patients were included to receive LTEVB12 initial therapy in this study. The patients with failure of IM regression continued to celecoxib receive rescue therapy. After each therapy finished, patients underwent endoscopy and biopsy examination. OLGA and OLGIM stages were applied to evaluate the reversal of atrophic gastritis (AG) and IM.
For LTEVB12 initial therapy, the reversal rates of IM and AG were 52.95% and 48.24%, respectively. For celecoxib rescue therapy, the effective rates for IM and AG were 56.25% and 51.56%, respectively. The IM regression rate of complete therapy was up to 85.03% (P < 0.05). For both therapies, patients with high stages (III or IV) of both OLGA and OLGIM evaluation systems showed a higher IM or AG regression rate than those patients with low stages (I or II). Among high stage (OLGIM III and IV) patients, the IM regression rate was above 70% for each therapy.
Each monotherapy could effectively reverse IM and AG. The LTEVB12 initial therapy and celecoxib rescue therapy, significantly increased the regression effect, which showed strong potential to reduce the risk of GC. IM may be not the point of no return among gastric precancerous lesions.
LTEVB12 initial therapy and celecoxib rescue therapy can achieve better effect on IM regression compared with either monotherapy. IM could be reversed by clinical intervention.