S1619 Prevalence of Gastrointestinal Inflammation Beyond the Small Intestine in Celiac Disease

Abstract

Methods: We prospectively analyzed the biopsies from 341 patients with IM and, at a minimum, biopsies of both antrum and oxyntic mucosa. Three gastrointestinal pathologists (RG, CR, KT) reviewed all cases and recorded the type and location of IM. In keeping with the recent AGA guidelines for the management of gastric IM, cases with IM in the oxyntic mucosa were classified as extensive; cases with mixed complete and incomplete IM were classified as incomplete IM. The percentage of incomplete IM in the 2 groups was compared by calculating odds ratios (OR with 95% CI). Results: There were 199 (58.4%) patients with limited IM and 142 (41.6%) with extensive IM. Among those with limited IM, 146 (73.3%) had complete IM and 53 (26.6%) had incomplete IM (Table ). Among those with extensive IM, 84 (59.2%) had complete IM and 58 (40.8%) had incomplete IM (OR 1.90; 1.20 -3.01; P, .01). Conclusion: Compared to patients with limited IM, patients with extensive IM had approximately twice the risk for incomplete IM. However, our study also shows that in patients with limited IM, who would not be considered at increased risk for dysplasia and GC by the AGA guidelines, over a quarter have incomplete IM, which would put them in the increased risk category. Therefore, relying solely on extent might result in the misclassification of patients who are at increased risk for dysplasia and GC. Until there are more robust methods to stratify risk in the evolving field of GC prevention, we suggest that optimal screening strategies can be substantially aided by reporting both extent and subtype of gastric IM.Introduction: In the US, 9.6% of the population (31 million people) do not have health insurance. Uninsured patients with cancer are more likely to present with advanced disease, not receive equal treatment, and display worse survival than those with insurance. Gastric cancer is one of the leading causes of death worldwide, and curative treatment depends on the disease stage at the time of diagnosis. The purpose of this study is to determine the association of insurance status with disease stage at presentation and survival among patients diagnosed with gastric cancer using the National Cancer Database (NCDB). Methods: The analysis cohort included gastric cancer patients in the NCDB diagnosed from 2010 to 2015. Patients were excluded if no information was available regarding insurance status or cancer staging at the time of diagnosis. Multivariable logistic regression models were used to determine the association between insurance status and gastric cancer stage at diagnosis/presentation. Cox regression models were used to determine the association between insurance status and all-cause mortality. Results: Following exclusions, 178,641 patients had gastric cancer during the study period. 171,199 patients (95.8%) had insurance in comparison to 7,442 patients (4.2%) who were uninsured. Univariate analysis between the groups demonstrated a statistically significant higher proportion of poor differentiation (53.2%), advanced disease (46.2%)...