Abstract:
Objective : To correlate body mass index (BMI) with the prevalence of early stage adenocarcinoma andintraepithelial neoplasia of the gastric cardia as detected by a population-based endoscopy survey.
Methods :In March 2004 through July 2006, patients aged 40 to 65 in 25 villages of two townships in Cixian Countywere selected for endoscopic screening. A total of 5,331 cases were recruited and 4,078 of them underwentendoscopic screening, providing a screening rate of 76.5%. The male/female ratio of these 4,078 patientswas 0.97 and the average age was 47.0 years. According to 2000 WHO pathological standards for tumors ofthe digestive system, mild cardia epithelial dysplasia was considered low-grade neoplasia (LIN), while severedysplasia and intramucosal carcinoma were considered high-grade intraepithelial neoplasia (HIN). This studyincluded 55 cases of LIN, 67 cases of HIN and 17 cases of early carcinoma of the gastric cardia. Chineseadult BMI classification criteria were as follows: underweight (<18.5), normal (18.5~23.9), overweight (24.0~27.9), and obese (≥28.0). The association of BMI with the pathological degree was investigated by R×C contingency table.
Results : For the male patients, when the BMI was 18.5-23.9, the proportion of normal tissue,LIN, HIN and invasive cancer was 62.3%, 64.1%, 81.0% and 83.0%, respectively. When the BMI was higherthan 24.0, the proportion of normal tissue, LIN, HIN and invasive cancer was 4.5%, 33.3%, 19.0% and 16.7%,respectively, with a statistical relevance (χ
2=6.675,
P>0.05). For the female patients, when the BMI was18.5-23.9, the proportion of normal tissue, LIN, HIN and invasive cancer was 51.7%, 56.3%, 70.0% and40.0%, respectively. When the BMI was higher than 24.0, the proportion of normal tissue, LIN, HIN and invasive cancer was 45.4%, 43.8%, 30.0% and 60.0%, respectively (χ
2=5.387,
P>0.05).
Conclusion : There seemsto be no correlation between BMI and the prevalence of intraepithelial neoplasia and early cancer in the gastric cardia for individuals in the areas of high-risk for esophageal cancer in northern China. BMI is not a significant risk factor for gastric cardiac cancer.