Sains Malaysiana 47(8)(2018): 1811–1818

http://dx.doi.org/10.17576/jsm-2018-4708-20

Risk Factors of Gastric Premalignant Lesion in Gastritis Patients

(Faktor Risiko Lesi Gastrik Premalignan pada Pesakit Gastritis)

GONTAR ALAMSYAH SIREGAR^1*, IDA PARWATI², TRI HANGGONO ACHMAD³

& YONI FUADAH SYUKRIANI⁴

¹Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Jl. Dr. T. Mansur No.5, Kampus USU, Medan 20155, Indonesia

²Department of Clinical Pathology, Faculty of Medicine, Universitas Padjadjaran, Jl. Raya Bandung Sumedang KM 21, Jatinangor 45363, Bandung, Indonesia

³Department of Biochemistry, Faculty of Medicine, Universitas Padjadjaran, Jl. Raya Bandung Sumedang KM 21, Jatinangor 45363, Bandung, Indonesia

⁴Department of Forensic and Legal Medicine, Faculty of Medicine, Universitas Padjadjaran, Jl. Raya Bandung Sumedang KM 21, Jatinangor 45363, Bandung, Indonesia

Diserahkan: 15 Januari 2018/Diterima: 23 April 2018

ABSTRACT

Gastric cancer is the second leading cause of cancer-related mortality and the fourth most common cancer globally. Gastric premalignant lesions are well known risk factors for the development of gastric cancer. The purpose of this study was to investigate the risk factors of gastric premalignant lesion. This cross-sectional study observed gastritis patients at Adam Malik General Hospital, Permata Bunda General Hospital, Universitas Sumatera Utara Hospital, all located in Medan, Indonesia. A total of 120 gastritis patients were included in this study. Patients were interviewed with a questionnaire to obtain demographic data, alcohol intake, smoking status, high salt diet and NSAID use. Diagnosis of Helicobacter pylori infection was made using positive results of the carbon-14 urea breath test (14C-UBT), rapid urease test, and/or immunohistochemistry. Endoscopy and biopsy were conducted to diagnose gastric premalignant lesion. Gastric premalignant lesion diagnosis was made when one or more of the following were present: Chronic atrophic gastritis, intestinal metaplasia, or dysplasia. Data were analysed using SPSS version 22. There were 35/120 (29.2%) of gastritis patients having gastric premalignant lesion. Multivariate analysis has shown that H. pylori infection, patients with family history of gastric cancer, alcohol consumption and Batak ethnic have increased risk to develop gastric premalignant lesion (p<0.05). All these results implied that risk factors of gastric premalignant lesion were H. pylori infection, family history of gastric cancer, alcohol intake and Batak ethnic.

Keywords: Gastric cancer; gastric premalignant lesion; Helicobacter pylori; risk factors

ABSTRAK

Kanser gastrik merupakan penyebab kedua terbesar dalam kejadian kematian berkaitan dengan kanser dan berada di tempat keempat dalam kejadian kanser yang paling sering terjadi di seluruh dunia. Faktor risiko yang terkenal dalam perkembangan kanser gastrik adalah lesi gastrik premalignan. Objektif penyelidikan ini adalah untuk mengkaji faktor risiko kejadian lesi gastrik premalignan. Kajian keratan rentas ini dilakukan pada pesakit gastritis di hospital yang berlokasi di Medan, Indonesia seperti Hospital Umum Adam Malik, Hospital Umum Permata Bunda dan Hospital Universiti Sumatera Utara. Jumlah pesakit gastriris yang terlibat dalam penyelidikan ini adalah seramai 120 orang. Pesakit ditemu duga dengan soal selidik yang merangkumi pertanyaan mengenai data demografi, pengunaan alkohol, status penghisapan rokok, diet yang mengandungi garam tinggi serta penggunaan ubat NSAID. Diagnosis pada infeksi Helicobacter pylori ditentukan daripada hasil positif pada ujian karbon-14 pernafasan urea (14C-UBT), ujian pantas urease dan/atau immunohistokimia. Endoskopi dan biopsi dijalankan untuk pendiagnosisan lesi gastrik premalignan. Diagnosis lesi gastrik premalignan dilakukan sekiranya salah satu daripada lesi ini ditemui: Gastritis atrofik kronik dan/atau metaplasia atau displasia usus. Data dianalisis dengan menggunakan SPSS versi 22. 35 daripada 120 (29.2%) pesakit gastritis mempunyai lesi gastrik premalignan. Analisis secara multivariat menunjukkan bahawa infeksi H. pylori, pesakit dengan sejarah keluarga kanser gastrik, penggunaan alkohol serta etnik Batak didapati meningkatkan risiko perkembangan lesi gastrik premalignan (p<0.05). Kesimpulannya, keputusan kajian menunjukkan bahawa faktor risiko terjadinya lesi gastrik premalignan adalah infeksi H. pylori, pesakit dengan sejarah keluarga kanser gastrik, penggunaan alkohol dan etnik Batak.

Kata kunci: Faktor risiko; Helicobacter pylori; kanser gastrik; lesi gastrik premalignant

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*Pengarang untuk surat-menyurat; email: gontarsir@gmail.com