Chronic tamoxifen use is associated with a decreased risk of intestinal metaplasia in human gastric epithelium

Chang Mo Moon, Seok Hyung Kim, Sang Kil Lee, Jiyeon Hyeon, Ja Seung Koo, Sangheun Lee, Jean S. Wang, Won Jae Huh, Shradha S. Khurana, Jason C. Mills

Research output: Contribution to journalArticle

Abstract

Background: Intestinal metaplasia (IM), a premalignant lesion, is associated with an increased risk of gastric cancer. Although estrogen exposure, including tamoxifen, has been studied in correlation with gastric cancer, little has been investigated about its effects on IM. Aims: Therefore, we investigated whether chronic tamoxifen use was associated with the risk of IM in human stomach. Methods: We evaluated 512 gastric biopsies from 433 female breast cancer patients that underwent endoscopic gastroduodenoscopy (EGD) ≥6 months after breast surgery. Histopathological findings were scored according to the updated Sydney classification. Demographic and clinical characteristics were also included to identify predictive factors for IM. Results: In a multivariate logistic regression analysis, age at EGD (odds ratio [OR], 1.04; P = 0.002), biopsies from antrum (OR 2.08; P <0.001), and Helicobacter pylori positivity (OR 1.68; P = 0.016) were significantly associated with an increased risk of IM, whereas chronic tamoxifen use (≥3 months) was associated with a decreased risk of IM (OR 0.59; P = 0.025). After stratifying by biopsy site, association between tamoxifen use and IM persisted for corpus (OR 0.42; P = 0.026) but not for antrum (OR 0.74; P = 0.327). In analysis limited to patients with follow-up EGD, chronic tamoxifen use also correlated with improved IM score compared to no tamoxifen use (improved, 77.8 vs. 22.2 %; no change, 65.4 vs. 34.6 %; worsened, 30.0 vs. 70.0 %; P = 0.019). Conclusions: This study suggests that chronic tamoxifen use can decrease the risk of IM in human stomach. The effect of tamoxifen is predominantly observed in the corpus.

Original languageEnglish (US)
Pages (from-to)1244-1254
Number of pages11
JournalDigestive Diseases and Sciences
Volume59
Issue number6
DOIs
StatePublished - 2014
Externally publishedYes

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Metaplasia
Tamoxifen
Stomach
Epithelium
Odds Ratio
Biopsy
Stomach Neoplasms
Helicobacter pylori
Estrogens
Breast
Logistic Models
Regression Analysis
Demography
Breast Neoplasms

Keywords

  • Corpus
  • Gastric epithelium
  • Intestinal metaplasia
  • Tamoxifen

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

Chronic tamoxifen use is associated with a decreased risk of intestinal metaplasia in human gastric epithelium. / Moon, Chang Mo; Kim, Seok Hyung; Lee, Sang Kil; Hyeon, Jiyeon; Koo, Ja Seung; Lee, Sangheun; Wang, Jean S.; Huh, Won Jae; Khurana, Shradha S.; Mills, Jason C.

In: Digestive Diseases and Sciences, Vol. 59, No. 6, 2014, p. 1244-1254.

Research output: Contribution to journalArticle

Moon, CM, Kim, SH, Lee, SK, Hyeon, J, Koo, JS, Lee, S, Wang, JS, Huh, WJ, Khurana, SS & Mills, JC 2014, 'Chronic tamoxifen use is associated with a decreased risk of intestinal metaplasia in human gastric epithelium', Digestive Diseases and Sciences, vol. 59, no. 6, pp. 1244-1254. https://doi.org/10.1007/s10620-013-2994-1
Moon, Chang Mo ; Kim, Seok Hyung ; Lee, Sang Kil ; Hyeon, Jiyeon ; Koo, Ja Seung ; Lee, Sangheun ; Wang, Jean S. ; Huh, Won Jae ; Khurana, Shradha S. ; Mills, Jason C. / Chronic tamoxifen use is associated with a decreased risk of intestinal metaplasia in human gastric epithelium. In: Digestive Diseases and Sciences. 2014 ; Vol. 59, No. 6. pp. 1244-1254.
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abstract = "Background: Intestinal metaplasia (IM), a premalignant lesion, is associated with an increased risk of gastric cancer. Although estrogen exposure, including tamoxifen, has been studied in correlation with gastric cancer, little has been investigated about its effects on IM. Aims: Therefore, we investigated whether chronic tamoxifen use was associated with the risk of IM in human stomach. Methods: We evaluated 512 gastric biopsies from 433 female breast cancer patients that underwent endoscopic gastroduodenoscopy (EGD) ≥6 months after breast surgery. Histopathological findings were scored according to the updated Sydney classification. Demographic and clinical characteristics were also included to identify predictive factors for IM. Results: In a multivariate logistic regression analysis, age at EGD (odds ratio [OR], 1.04; P = 0.002), biopsies from antrum (OR 2.08; P <0.001), and Helicobacter pylori positivity (OR 1.68; P = 0.016) were significantly associated with an increased risk of IM, whereas chronic tamoxifen use (≥3 months) was associated with a decreased risk of IM (OR 0.59; P = 0.025). After stratifying by biopsy site, association between tamoxifen use and IM persisted for corpus (OR 0.42; P = 0.026) but not for antrum (OR 0.74; P = 0.327). In analysis limited to patients with follow-up EGD, chronic tamoxifen use also correlated with improved IM score compared to no tamoxifen use (improved, 77.8 vs. 22.2 {\%}; no change, 65.4 vs. 34.6 {\%}; worsened, 30.0 vs. 70.0 {\%}; P = 0.019). Conclusions: This study suggests that chronic tamoxifen use can decrease the risk of IM in human stomach. The effect of tamoxifen is predominantly observed in the corpus.",
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T1 - Chronic tamoxifen use is associated with a decreased risk of intestinal metaplasia in human gastric epithelium

AU - Moon, Chang Mo

AU - Kim, Seok Hyung

AU - Lee, Sang Kil

AU - Hyeon, Jiyeon

AU - Koo, Ja Seung

AU - Lee, Sangheun

AU - Wang, Jean S.

AU - Huh, Won Jae

AU - Khurana, Shradha S.

AU - Mills, Jason C.

PY - 2014

Y1 - 2014

N2 - Background: Intestinal metaplasia (IM), a premalignant lesion, is associated with an increased risk of gastric cancer. Although estrogen exposure, including tamoxifen, has been studied in correlation with gastric cancer, little has been investigated about its effects on IM. Aims: Therefore, we investigated whether chronic tamoxifen use was associated with the risk of IM in human stomach. Methods: We evaluated 512 gastric biopsies from 433 female breast cancer patients that underwent endoscopic gastroduodenoscopy (EGD) ≥6 months after breast surgery. Histopathological findings were scored according to the updated Sydney classification. Demographic and clinical characteristics were also included to identify predictive factors for IM. Results: In a multivariate logistic regression analysis, age at EGD (odds ratio [OR], 1.04; P = 0.002), biopsies from antrum (OR 2.08; P <0.001), and Helicobacter pylori positivity (OR 1.68; P = 0.016) were significantly associated with an increased risk of IM, whereas chronic tamoxifen use (≥3 months) was associated with a decreased risk of IM (OR 0.59; P = 0.025). After stratifying by biopsy site, association between tamoxifen use and IM persisted for corpus (OR 0.42; P = 0.026) but not for antrum (OR 0.74; P = 0.327). In analysis limited to patients with follow-up EGD, chronic tamoxifen use also correlated with improved IM score compared to no tamoxifen use (improved, 77.8 vs. 22.2 %; no change, 65.4 vs. 34.6 %; worsened, 30.0 vs. 70.0 %; P = 0.019). Conclusions: This study suggests that chronic tamoxifen use can decrease the risk of IM in human stomach. The effect of tamoxifen is predominantly observed in the corpus.

AB - Background: Intestinal metaplasia (IM), a premalignant lesion, is associated with an increased risk of gastric cancer. Although estrogen exposure, including tamoxifen, has been studied in correlation with gastric cancer, little has been investigated about its effects on IM. Aims: Therefore, we investigated whether chronic tamoxifen use was associated with the risk of IM in human stomach. Methods: We evaluated 512 gastric biopsies from 433 female breast cancer patients that underwent endoscopic gastroduodenoscopy (EGD) ≥6 months after breast surgery. Histopathological findings were scored according to the updated Sydney classification. Demographic and clinical characteristics were also included to identify predictive factors for IM. Results: In a multivariate logistic regression analysis, age at EGD (odds ratio [OR], 1.04; P = 0.002), biopsies from antrum (OR 2.08; P <0.001), and Helicobacter pylori positivity (OR 1.68; P = 0.016) were significantly associated with an increased risk of IM, whereas chronic tamoxifen use (≥3 months) was associated with a decreased risk of IM (OR 0.59; P = 0.025). After stratifying by biopsy site, association between tamoxifen use and IM persisted for corpus (OR 0.42; P = 0.026) but not for antrum (OR 0.74; P = 0.327). In analysis limited to patients with follow-up EGD, chronic tamoxifen use also correlated with improved IM score compared to no tamoxifen use (improved, 77.8 vs. 22.2 %; no change, 65.4 vs. 34.6 %; worsened, 30.0 vs. 70.0 %; P = 0.019). Conclusions: This study suggests that chronic tamoxifen use can decrease the risk of IM in human stomach. The effect of tamoxifen is predominantly observed in the corpus.

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