Al-Knawy B, Morad N, Jamal A, Mirdad S, Abol Fotouh M, Ahmed M E, Saydain G, Seidi O, Shatoor A
Dept. of Medicine, King Saud University, Abha, Saudi Arabia.
Scand J Gastroenterol. 1999 Jun;34(6):562-5. doi: 10.1080/003655299750026001.
There is a close association between intestinal metaplasia (IM) and the development of gastric cancer as well as a relationship between Helicobacter pylori, IM, and gastric cancer. Our aim was to study the frequency and subtypes of IM in a Saudi population with dyspepsia, a population with a low prevalence of gastric cancer.
Endoscopic antral biopsy specimens were histologically studied for the presence of IM and H. pylori in consecutive patients who underwent upper gastrointestinal endoscopy for evaluation of dyspepsia. Hematoxylin and eosin and Giemsa stain were used to study IM, inflammation, and H. pylori, whereas Alcian blue, pH 2.5/periodic acid-Schiff and high iron diamine/Alcian blue, pH 2.5, were used to study IM subtypes.
Seven hundred and seventy-eight consecutive patients were recruited in this study, 415 men and 363 women, with a mean age of 43 +/- 17.6 years. Of the 778 patients, IM was identified in 118 (15.2%). The mean ages of patients with IM (48.8 +/- 18.7) and without IM (41.9 +/- 17.4) were statistically significant (P < 0.0001), whereas the patients' sex did not influence the presence of IM. Most had type-I IM (59.3%), whereas 26.3% and 14.4% had types II and III, respectively. The overall rate of infection with H. pylori was 75.4%. There was no difference in the frequency of IM in patients with or without H. pylori (15.5% versus 14.1%; P = 0.65). Of the 118 patients with IM, the 91 patients (77.1%) who also had H. pylori were older (55 +/- 23 years) than those without H. pylori (47 +/- 17 years, P = 0.05).
This study has documented mainly that the prevalence of IM and IM subtype III is low in our population. Furthermore, we found no significant relationship between a high rate of H. pylori infection with either IM in general or with IM subtype III in particular, possibly accounting for a low incidence of gastric cancer in the Saudi population.
肠化生（IM）与胃癌的发生密切相关，同时幽门螺杆菌、IM和胃癌之间也存在关联。我们的目的是研究在胃癌患病率较低的沙特消化不良人群中IM的发生率及亚型。
对因消化不良接受上消化道内镜检查的连续患者的内镜下胃窦活检标本进行组织学研究，以检测IM和幽门螺杆菌的存在。苏木精-伊红染色和吉姆萨染色用于研究IM、炎症和幽门螺杆菌，而阿尔辛蓝（pH 2.5）/过碘酸-希夫染色以及高铁二胺/阿尔辛蓝（pH 2.5）用于研究IM亚型。
本研究共纳入778例连续患者，其中男性415例，女性363例，平均年龄43±17.6岁。在778例患者中，118例（15.2%）发现有IM。有IM的患者（48.8±18.7岁）和无IM的患者（41.9±17.4岁）的平均年龄在统计学上有显著差异（P<0.0001），而患者的性别不影响IM的存在。大多数患者为I型IM（59.3%），而II型和III型分别占26.3%和14.4%。幽门螺杆菌的总体感染率为75.4%。有或无幽门螺杆菌感染的患者中IM的发生率无差异（15.5%对14.1%；P = 0.65）。在118例有IM的患者中，同时感染幽门螺杆菌的91例患者（77.1%）比未感染幽门螺杆菌的患者年龄更大（55±23岁对47±17岁，P = 0.05）。
本研究主要记录了我们人群中IM及III型IM的患病率较低。此外，我们发现幽门螺杆菌高感染率与一般IM或特别是III型IM之间无显著关系，这可能是沙特人群胃癌发病率低的原因。
