Kgomo M, Elnagar A, Nagel J and Mokoena T
Recent studies in Sweden and Japan have reported that extensive gastric atrophy is associated with an increased risk for oesophageal squamous cell carcinoma. They also mentioned that this findings need to be confirmed in other ethnic groups due to the wide geographic variation of this cancer. Objectives: To determine the prevalence of extensive gastric atrophy in patients with squamous cell carcinoma of the oesophagus over a two year period. Method: Fifty nine patients with squamous cell carcinoma of the oesophagus referred to gastroenterology division for dilatation or stenting had four additional biopsies taken from the gastric antrum and corpus. This were then evaluated for the presence gastric atrophy and Helicobacter pylori by an experienced histopathologist. Results: Extensive gastric atrophy defined as atrophy of both the antrum and the corpus was found in 15(25%) of the fifty nine patients. Nine (60%) of these patients were also positive for Helicobacter pylori by methylene blue. Conclusion: The prevalence of extensive gastric atrophy in these patients with squamous cell carcinoma of the oesophagus is much lower than that found in Sweden and Japan, i.e. less than half of these two regions and the majority of them were found to be infected by h pylori. . This suggest that even though extensive gastric atrophy is an important factor in certain areas, it may be less important of a factor in South Africa and other geographic areas as shown in other studies. This still need to be investigated further in larger studies to fully understand the role of extensive gastric atrophy in these patients.
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