{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T13:13:40Z","timestamp":1791119620540,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2003,12,11]],"date-time":"2003-12-11T00:00:00Z","timestamp":1071100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2004,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We conducted a longitudinal cohort study to determine the association of\n                    <jats:italic>Helicobacter pylori<\/jats:italic>\n                    infection and the progression of chronic atrophic gastritis (CAG) with gastric cancer. A cohort of 4,655 healthy asymptomatic subjects was followed for a mean period of 7.7 years.\n                    <jats:italic>H. pylori<\/jats:italic>\n                    infection was established by serum specific antibodies and the presence of CAG was confirmed by serum pepsinogen. During the follow\u2010up period, 45 gastric cancer cases were detected (incidence rate, 126\/100,000 person\u2010years). A univariate analysis after adjustment for age showed that both\n                    <jats:italic>H. pylori<\/jats:italic>\n                    and CAG were significantly associated with gastric cancer. To clarify the interaction between\n                    <jats:italic>H. pylori<\/jats:italic>\n                    and CAG, an analysis stratified by\n                    <jats:italic>H. pylori\u2010<\/jats:italic>\n                    and CAG\u2013status was performed. No cancer developed in the\n                    <jats:italic>H. pylori<\/jats:italic>\n                    (\u2212)\/CAG(\u2212) group during the study period. This supports the theory that it is quite rare for any type of gastric cancer to develop in an\n                    <jats:italic>H. pylori<\/jats:italic>\n                    \u2010free healthy stomach. With the progression of\n                    <jats:italic>H. pylori<\/jats:italic>\n                    \u2010induced gastritis, the risk of gastric cancer increased in a stepwise fashion from CAG\u2010free gastritis [\n                    <jats:italic>H. pylori<\/jats:italic>\n                    (+)\/CAG(\u2212) group] (HR=7.13, 95%CI=0.95\u201053.33) to CAG [\n                    <jats:italic>H. pylori<\/jats:italic>\n                    (+)\/CAG(+) group] (HR=14.85, 95%CI=1.96\u2013107.7) and finally to severe CAG with extensive intestinal metaplasia [\n                    <jats:italic>H. pylori<\/jats:italic>\n                    (\u2212)\/CAG(+) group] (HR=61.85, 95%CI=5.6\u2013682.64) in which loss of\n                    <jats:italic>H. pylori<\/jats:italic>\n                    from the stomach is observed. Therefore, it is probable that\n                    <jats:italic>H. pylori<\/jats:italic>\n                    alone is not directly associated with stomach carcinogenesis. Instead,\n                    <jats:italic>H. pylori<\/jats:italic>\n                    appears to influence stomach carcinogenesis through the development of CAG. The observed positive correlation between the extent of\n                    <jats:italic>H. pylori<\/jats:italic>\n                    \u2010induced gastritis and the development of cancer was strong, especially for the intestinal type. These results are compelling evidence that severe gastritis with extensive intestinal metaplasia is a major risk factor for gastric cancer, and they confirm the previously described model of stomach carcinogenesis: the gastritis\u2010metaplasia\u2010carcinoma sequence. \u00a9 2003 Wiley\u2010Liss, Inc.\n                  <\/jats:p>","DOI":"10.1002\/ijc.11680","type":"journal-article","created":{"date-parts":[[2004,1,16]],"date-time":"2004-01-16T05:00:36Z","timestamp":1074229236000},"page":"138-143","source":"Crossref","is-referenced-by-count":418,"title":["Progression of chronic atrophic gastritis associated with\n                    <i>Helicobacter pylori<\/i>\n                    infection increases risk of gastric 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