Evolution of the Correa's cascade steps: A long-term endoscopic surveillance among non-ulcer dyspepsia and gastric ulcer after H. pylori eradication

Hsiu Chi Cheng, Yao Jong Yang, Hsiao Bai Yang, Yu Ching Tsai, Wei Lun Chang, Chung Tai Wu, Hsin Yu Kuo, Yu Ting Yu, Er Hsiang Yang, Wei Chun Cheng, Wei Ying Chen, Bor Shyang Sheu

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background: This study is aimed toward investigating the evolution of each Correa's step after Helicobacter pylori eradication in a long-term follow-up and exploring the factors correlated with a high-risk of gastric cancer. Methods: A total of 1824 H. pylori-infected subjects were enrolled to receive screening endoscopy. Among them, 491 received surveillance endoscopy. The patients were divided into Correa's steps I to VI, from normal to gastric cancer. A group-based trajectory model was used to classify patients as persistent high-risk status or not. Results: The prevalence rates of positive corpus-predominant gastritis index (CGI) were 20%–40% in all age groups and Correa's steps IV-V increased >35% after 50 years based on screening endoscopy. Successful eradication of H. pylori regressed CGI after the 1st year-and-thereafter (P < 0.05) and decreased Correa's step progression (Relative risk 0.66 [95% CI 0.49–0.89], P = 0.01); however, it did not regress OLGA and OLGIM. Not only in steps IV-V, but also in step III, the patients had a risk of developing gastric cancer (11.13–76.41 and 4.61 per 1000 person-years). Age (Hazard ratio 1.012 [1.003–1.020], P = 0.01), OLGA stages ≥ I (2.127 [1.558–2.903], P < 0.001), and OLGIM stages ≥ I (1.409 [1.119–1.774], P = 0.004) were correlated independently with a persistent high-risk status. Conclusion: The patients in Correa's steps III-V, but not I-II, were at risk of gastric cancer after H. pylori eradication. Age, OLGA stages ≥ I, and OLGIM stages ≥ I were independent factors correlated to a persistent high-risk of gastric cancer. The data may be useful when scheduling surveillance endoscopy for subjects in each Correa's step (NCT04527055).

Original languageEnglish
Pages (from-to)400-410
Number of pages11
JournalJournal of the Formosan Medical Association
Volume122
Issue number5
DOIs
Publication statusPublished - 2023 May

All Science Journal Classification (ASJC) codes

  • General Medicine

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