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Patients with Helicobacter pylori infection are at increased risk for adenocarcinoma of the stomach. Although progression from H. pylori to cancer is preceded by intestinal metaplasia (IM), most patients with IM do not develop cancer. To identify the parameters associated with the highest risk for gastric cancer in this clinical context — and therefore patients with the greatest need for endoscopic surveillance — researchers in the Netherlands studied 88 consecutive outpatients who had been diagnosed with IM of the gastric mucosa.
Each patient completed a detailed questionnaire, underwent baseline and surveillance endoscopy, had biopsies taken from five standard locations, and underwent serologic testing for H. pylori, cagA, pepsinogens I an…