INTRODUCTION Corpus atrophic gastritis (CAG) is associated with intestinal metaplasia (IM) and pseudopyloric metaplasia (PPM). Prospective data on corpus mucosa PPM and its link to the development of gastric cancer (GC) are lacking. This study aimed to investigate the relationship between the presence of corpus mucosa PPM at baseline and the development of GC at follow-up in patients with CAG. METHODS A longitudinal cohort study was conducted on patients with consecutive CAG adhering to endoscopic-histological surveillance. Patients were stratified for the presence/absence of corpus PPM without concomitant corpus IM at baseline, and the occurrence of gastric neoplastic lesions at the longest available follow-up was assessed. RESULTS A total of 292 patients with CAG with a follow-up of 4.2 (3-17) years were included. At baseline, corpus PPM without corpus IM was diagnosed in 62 patients (21.2%). At the follow-up, GC was detected in 5 patients (1.7%) and gastric dysplasia (GD) in 4 patients (1.4%). In all these 9 patients with GC/GD at the follow-up, corpus IM was present at baseline and follow-up. Age <50 years (odds ratio [OR] 2.5), absence of pernicious anemia (OR 4.3), and absence of severe corpus atrophy (OR 2.3) were associated with corpus PPM without corpus IM. DISCUSSION At the 4.2-year follow-up, in patients with CAG characterized at baseline with corpus PPM without corpus IM, GC or GD was not observed because these lesions were consistently associated with corpus IM. Corpus PPM without corpus IM was associated with younger age, absence of pernicious anemia, and severe corpus atrophy, suggesting a lower stage of disease progression. Corpus PPM alone seems not to be associated with GC, whose development seems to require the presence of corpus IM as a necessary step.

中文翻译：

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假幽门化生与胃癌的发展无关。

简介 胃体萎缩性胃炎 (CAG) 与肠化生 (IM) 和假幽门化生 (PPM) 相关。缺乏关于粘膜 PPM 及其与胃癌 (GC) 发展之间关系的前瞻性数据。本研究旨在探讨 CA​​G 患者基线时粘膜 PPM 的存在与随访时 GC 发生之间的关系。方法 对坚持内镜组织学监测的连续 CAG 患者进行纵向队列研究。对基线时患者是否存在 PPM 且不伴有 IM 进行分层，并评估最长随访期间胃肿瘤病变的发生情况。结果 共纳入 292 例 CAG 患者，随访时间为 4.2（3-17）年。在基线处，62 名患者 (21.2%) 诊断为 corpus PPM 而无 corpus IM。随访时，5 名患者（1.7%）检出 GC，4 名患者（1.4%）检出胃不典型增生（GD）。在所有这 9 名随访时患有 GC/GD 的患者中，基线和随访时均存在肌体 IM。年龄<50岁（优势比[OR]2.5）、无恶性贫血（OR 4.3）和无严重语料库萎缩（OR 2.3）与语料库PPM（无语料库IM）相关。讨论 在 4.2 年随访中，在基线时特征为具有体部 PPM 而无体部 IM 的 CAG 患者中，未观察到 GC 或 GD，因为这些病变始终与体部 IM 相关。没有语体 IM 的语体 PPM 与年龄较小、无恶性贫血和严重语体萎缩有关，表明疾病进展处于较低阶段。