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High prevalence of Helicobacter pylori infection and pre-neoplastic gastric lesion found in family relatives of gastric cancer patients
The Institute of Digestive Disease of the Faculty of Medicine, The Chinese University of Hong Kong has performed a screening study of family relatives of gastric cancer patients. Between 2001 and 2004, 270 first degree relatives (sibling and offspring) of gastric cancer patients were screened by using upper gastrointestinal endoscopy to determine the prevalence of H. pylori infection and pre-neoplastic lesions in the stomach. During screening endoscopy, we discovered 2 (0.8%) early gastric neoplasm and 11 peptic ulcer in these asymptomatic relatives. The prevalence of H. pylori infection was found to be significantly higher in gastric cancer relatives (59.6%) as compared to age- and sex-matched controls without family history of gastric cancer (45.5%). Moreover, 30% of gastric cancer relatives had intestinal metaplasia (IM), a pre-neoplastic lesion, in the stomach. Risk factors associated the presence of IM in gastric cancer relatives are: H. pylori infection, male gender, age and a history of gastric cancer in siblings. Results from this study indicate a higher prevalence of H. pylori infection and pre-neoplastic gastric lesions in family members of gastric cancer patients. Screening of gastric cancer relatives by endoscopy may be beneficial in detecting H. pylori infection and early gastric lesions. To enhance the early detection of pre-neoplastic gastrointestinal lesions, the Institute of Digestive Disease has recently acquired a novel endoscopic imaging technique. This technology called the narrow band imaging (NBI), which consists of a sequential electronic endoscope system and a source of light equipped with new narrow band filters, helps to identify early neoplastic lesions in the gastric mucosa. The Institute of Digestive Disease will embark on a study to evaluate the role of NBI on screening of pre-neoplastic gastric lesion in gastric cancer relatives. |