{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T15:44:47Z","timestamp":1773675887222,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,8,11]],"date-time":"2017-08-11T00:00:00Z","timestamp":1502409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients who have undergone endoscopic resection of early gastric cancers (<jats:styled-content style=\"fixed-case\">EGC<\/jats:styled-content>s) are at risk for metachronous gastric neoplasm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine whether serum level of pepsinogen (<jats:styled-content style=\"fixed-case\">PG<\/jats:styled-content>), a marker of gastric atrophy, can determine which patients who have undergone endoscopic submucosal dissection for <jats:styled-content style=\"fixed-case\">EGC<\/jats:styled-content> are at risk for metachronous gastric neoplasm. We also investigated the effects of <jats:italic>Helicobacter pylori<\/jats:italic> eradication on metachronous gastric neoplasm incidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective study of 590 consecutive patients who underwent endoscopic submucosal dissection for <jats:styled-content style=\"fixed-case\">EGC<\/jats:styled-content>, from January 2008 to May 2013 at a tertiary centre in South Korea; serum levels of <jats:styled-content style=\"fixed-case\">PG<\/jats:styled-content> were measured at the time of endoscopic submucosal dissection and <jats:italic>H. pylori<\/jats:italic> infection status were recorded. In case of proven presence of current <jats:italic>H. pylori<\/jats:italic> infection, eradication treatment was provided. Patients underwent follow\u2010up endoscopies at 3 months, 9 months, and each year after the procedure to detect neoplasms and were tested for <jats:italic>H. pylori<\/jats:italic> infection; serum levels of <jats:styled-content style=\"fixed-case\">PG<\/jats:styled-content> were measured at these time points from 442 of the patients. The main and sub\u2010cohorts were assessed for baseline characteristics, <jats:italic>H. pylori<\/jats:italic> infection, serum level of <jats:styled-content style=\"fixed-case\">PG<\/jats:styled-content>, and metachronous gastric neoplasm lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During a median follow\u2010up period of 47.7 months, 64 patients developed metachronous gastric neoplasms. In multivariate analysis of the main cohort (n = 590), risk factors for metachronous gastric neoplasm included persistent <jats:italic>H. pylori<\/jats:italic> infection (hazard ratio [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>], 2.532; <jats:italic>P<\/jats:italic> = .022) and serum ratio of <jats:styled-content style=\"fixed-case\">PGI<\/jats:styled-content>:<jats:styled-content style=\"fixed-case\">PGII<\/jats:styled-content> of three or less at the time of endoscopic submucosal dissection (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>, 1.881; <jats:italic>P<\/jats:italic> = .018). Among patients with serum <jats:styled-content style=\"fixed-case\">PG<\/jats:styled-content> measurements, persistent <jats:italic>H. pylori<\/jats:italic> infection (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>], 4.404; <jats:italic>P<\/jats:italic> = .009) and persistent decrease in mean serum ratio of <jats:styled-content style=\"fixed-case\">PGI<\/jats:styled-content>:<jats:styled-content style=\"fixed-case\">PGII<\/jats:styled-content> to 3 or less were associated with increased risk of metachronous gastric neoplasm (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 2.141; <jats:italic>P<\/jats:italic> = .039).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a retrospective analysis of patients who underwent endoscopic resection of <jats:styled-content style=\"fixed-case\">EGC<\/jats:styled-content>s, eradication of <jats:italic>H. pylori<\/jats:italic> infection reduced risk for metachronous gastric neoplasm. Serum ratio of <jats:styled-content style=\"fixed-case\">PGI<\/jats:styled-content>:<jats:styled-content style=\"fixed-case\">PGII<\/jats:styled-content> of 3 or less also increase risk of metachronous gastric neoplasm after endoscopic submucosal dissection. ClinicalTrials.gov. registry number, <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>02682446.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14263","type":"journal-article","created":{"date-parts":[[2017,8,11]],"date-time":"2017-08-11T07:42:38Z","timestamp":1502437358000},"page":"758-767","source":"Crossref","is-referenced-by-count":23,"title":["<i>Helicobacter pylori<\/i> infection and serum level of pepsinogen are associated with the risk of metachronous gastric neoplasm after endoscopic resection"],"prefix":"10.1111","volume":"46","author":[{"given":"Y.","family":"Kwon","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Kyungpook National University School of Medicine Daegu Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9539-9389","authenticated-orcid":false,"given":"S.","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kyungpook National University School of Medicine Daegu Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5568-7714","authenticated-orcid":false,"given":"S.","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kyungpook National University School of Medicine Daegu Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Shin","sequence":"additional","affiliation":[{"name":"The Department of Medical Statistics and Informatics Catholic University of Daegu School of Medicine Daegu Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,8,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-006-0408-1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-010-0347-9"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12633"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-013-0861-7"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.404"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61159-9"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12146"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.09.057"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1443-1661.2009.00839.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.24591"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(82)90176-7"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28470"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02734.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-009-0522-y"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-006-0397-0"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000050"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-016-0622-4"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.47.2.251"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.08.030"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301647"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12687"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1349-7006.2005.00098.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000173719"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30145"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1472-8206.2005.00348.x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.00022.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2002.01346.x"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2002.01336.x"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.291.2.187"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2015.05.014"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200308000-00009"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-5378.2001.00031.x"}],"container-title":["Alimentary Pharmacology &amp; 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