Tu1716 Characterization of Helicobacter pylori-Negative Gastric Cancer

Tu1714 Gastric Cancer: Are WE Missing the Opportunity of Early Diagnosis? Ramiro Tapia-Sosa*, Luis Uscanga Gastroenterology, Instituto de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico Background/Aims: Gastric Cancer (GC) is the third-leading cause of death from Cancer in Mexico. Based on the diagnosis and treatment guidelines of this country, the upper gastrointestinal endoscopy (UGE) with biopsy is the most efficient procedure to identify this disease. We aim to know the number of patients, and their clinical features, who have had at least one UGE before the definitive diagnosis of GC. Methods: All the patient medical files with GC who were admitted to a health Institute in Mexico City in a period of 5 years were reviewed. The total subjects were divided into: Group A, those with only one UGE performed to establish the GC diagnosis, and Group B, those patients who had more than one procedure before the identification of GC within a maximum period of 24 months. Results: One hundred and twelve patients with GC were diagnosed with GC. Group A was 70% (78/112) of the total population under study and Group B consisted of the remaining 30% (34/112). The time between the onset of symptoms and the diagnosis of this disease was statistically significantly (p!0.05) greater in the latter group (Table 1). Twenty-six of the 34 patients of Group B had an endoscopic view consistent with neoplasm; however, they were not histologically confirmed. The remaining eight were not suspected of neoplasm neither endoscopically nor microscopically. An important number of patients (11%) of the study group had a delayed diagnosis due to a time between studies greater than 6 months. The variable that implied a risk for delayed diagnosis of GC was the use of proton pump inhibitors (HR 3.2, CI 95% 1.4 7.2) which also has an effect on prognosis (Table 2). Conclusions: The majority of patients with a previous UGE had a macroscopic image that suggested GC which forces the physician to recheck the tissue under microscope or, if it were the case, repeat the study. Table 1. Univariate analysis: Group A vs B