Studies of Patients with Atrophic Gastritis: a 10-15-Year Follow-up

Abstract

Of 100 patients with atrophic gastritis, 49 were re-examined 10-15 years after the first and 5-8 years after the second examination, 18 patients answered a questionnaire but declined the re-examination, 18 had died during the last follow-up period, and from 15 patients no direct information was obtained. Two of the deceased patients had died of gastric carcinoma. Gastric carcinoma was found at re-examination in a third patient. In this patient transition of intestinal metaplasia into cancer tissue was observed histologically. During the first follow-up period six additional patients had developed gastric carcinoma. Thus nine patients in all had died of gastric carcinoma or it had been found at re-examination. Polyps were found at re-examinations in two patients. None of 168 patients with a normal gastric mucosa and of 93 patients with superficial gastritis had died of gastric carcinoma during the same follow-up periods. The ordinary Schilling test revealed low urinary radioactivity values in 4, low normal (5-10 per cent) in 7 and normal in 35 patients. The serum vitamin B₁₂ value was low in 3, low normal (100-200 μg/ml) in 7 and normal in 41 patients. One patient developed true pernicious anemia during the follow-up period. There was a fairly good correlation between the degree of gastritis on the one hand and the results of Schilling tests and vilamin B_l2 determinations on the other hand. Of 45 patients re-biopsied, 8 showed progression and 7 some signs of remission. However, normalization of the body gland layer was seen in only one patient, and even in this case signs of superficial inflammation persisted, fn the remaining 30 patients the atrophic process remained unchanged in spite of the long follow-up period.