The prevalence of gastric intestinal metaplasia in the Saudi population: a single-tertiary center retrospective study.

BACKGROUND

Gastric intestinal metaplasia (GIM) is characterized by the transformation of gastric mucosa into an intestinal phenotype. This condition arises from gastric cell inflammation caused by various etiologies, such as infection or autoimmune reactions. GIM is a critical stage in the carcinogenic pathway and may progress into gastric cancer (GC), one of the most prevalent and morbid cancers worldwide. In this study, we examined the prevalence of GIM among patients who underwent upper endoscopy or gastric resection, along with associated risk factors.

METHODS

This retrospective study included 2,103 patients who underwent upper endoscopy or gastric resection at a tertiary facility. Data on patient demographics, risk factors, procedural indications and tissue sampling were collected and analyzed.

RESULTS

GIM was identified in 119 patients (5.7%) who had significantly higher mean age (55.83±15.88 years, P value <0.001) compared to the non-GIM group. Among all patients, 547 had Helicobacter pylori (H. pylori) infection. Coexisting dysplasia was present in 42 patients and cancer was detected in 47 patients. H. pylori positivity was significantly higher in the GIM group (P value <0.001). Additionally, the GIM group showed a significantly higher prevalence of cancer and dysplasia (P value of 0.001 for both).

CONCLUSIONS

A significantly higher proportion of patients with GIM had coexisting GC and dysplasia. Advanced age and H. pylori were strongly associated with GIM. Our findings support the well-established link between H. pylori infection and the increased risk of dysplasia and cancer progression.