Kyoto Classification-Based Predictive Factors Associated with the Development of Gastric Cancer After Helicobacter...

Area of Science:

• Gastroenterology
• Oncology
• Endoscopy

Background:

• Gastric cancer (GC) remains a significant health concern globally.
• Helicobacter pylori (H. pylori) infection is a primary risk factor for GC.
• Successful H. pylori eradication is crucial but does not eliminate GC risk entirely.

Purpose of the Study:

• To identify specific endoscopic findings predicting GC development post-H. pylori eradication.
• To analyze the association between endoscopic features and GC incidence using the Kyoto Classification of Gastritis.
• To establish early predictive indicators for GC in patients after H. pylori eradication.

Main Methods:

• Prospective multicenter observational study.
• Inclusion of patients undergoing annual surveillance endoscopy post-H. pylori eradication (Sept 2013 - June 2019).
• Analysis of endoscopic findings using the Kyoto Classification of Gastritis.

Main Results:

• 465 patients included; 49 developed GC.
• Map-like redness (HR 2.561) and invisible RAC (HR 3.131) identified as independent GC predictors.
• Significantly higher GC incidence in patients with map-like redness or invisible RAC (p < 0.001).
• Map-like redness and visible RAC observed in 13% and 28.4% within one year post-eradication.

Conclusions:

• Map-like redness and invisible RAC are significant independent predictors of GC after H. pylori eradication.
• These endoscopic findings serve as early indicators of elevated GC risk.
• Early surveillance endoscopy is vital for identifying high-risk patients post-eradication.