Guarner J, Herrera-Goepfert R, Mohar A, Sanchez L, Halperin D, Ley C, Parsonnet J
Infectious Diseases Pathology Activity, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
Hum Pathol. 2001 Jan;32(1):31-5. doi: 10.1053/hupa.2001.20889.
Atrophy and intestinal metaplasia (IM) are preneoplastic gastric lesions associated with Helicobacter pylori infection. Atrophy and IM are usually found together; however, the association between increasing degrees of severity of both atrophy and IM has not been evaluated completely. Two pathologists graded atrophy and IM using the visual analog scale of the Sydney classification in gastric biopsies from 368 H pylori-infected patients. Extent of IM also included determining the number of specimens affected. We then correlated the degree of atrophy with the degree and number of specimens affected with IM by calculating relative risks (RR) and 95% confidence intervals (95% CI). The mean number of biopsies examined from each patient was 6.5. Atrophy and IM were found more frequently in the antrum (85% and 75% of biopsies, respectively). One hundred thirty-eight patients had a combination of atrophy and IM, 48 had IM only, and 89 had atrophy only. Fifty-three subjects had mild atrophy and IM (RR = 1.57; 95% CI 1.2-2.1), 69 had moderate atrophy and IM (RR = 1.86; 95% CI 1.9-2.4), and 16 had marked atrophy and IM (RR = 2.47; 95% CI 1.8-3.3). The median number of biopsy specimens with IM increased from 0 in subjects with no atrophy to 3 in subjects with severe atrophy. The degree of IM correlated with the degree of atrophy; the median degree was 0.6 in subjects with no atrophy and increased to 2.32 in those with severe atrophy. Our data suggest that higher degrees of IM in an individual specimen and increasing number of specimens with IM are associated with moderate or severe degrees of atrophy.
萎缩和肠化生（IM）是与幽门螺杆菌感染相关的癌前胃病变。萎缩和IM通常同时出现；然而，萎缩和IM严重程度增加之间的关联尚未得到全面评估。两名病理学家使用悉尼分类的视觉模拟量表对368例幽门螺杆菌感染患者的胃活检标本中的萎缩和IM进行分级。IM的范围还包括确定受影响标本的数量。然后，我们通过计算相对风险（RR）和95%置信区间（95%CI），将萎缩程度与受IM影响的标本程度和数量进行关联分析。每位患者检查的活检标本平均数量为6.5个。萎缩和IM在胃窦部更常见（分别占活检标本的85%和75%）。138例患者同时存在萎缩和IM，48例仅存在IM，89例仅存在萎缩。53例患者有轻度萎缩和IM（RR = 1.57；95%CI 1.2 - 2.1），69例有中度萎缩和IM（RR = 1.86；95%CI 1.9 - 2.4），16例有重度萎缩和IM（RR = 2.47；95%CI 1.8 - 3.3）。有IM的活检标本中位数数量从无萎缩患者的0个增加到重度萎缩患者的3个。IM的程度与萎缩程度相关；无萎缩患者的中位数程度为0.6，重度萎缩患者则增至2.32。我们的数据表明，单个标本中较高程度的IM以及有IM的标本数量增加与中度或重度萎缩相关。
