Chen X Y, van Der Hulst R W, Shi Y, Xiao S D, Tytgat G N, Ten Kate F J
Department of Pathology, Renji Hospital, Shanghai Second Medical University, Shanghai Institute of Digestive Disease, Shanghai (200001), China.
J Clin Pathol. 2001 May;54(5):367-70. doi: 10.1136/jcp.54.5.367.
AIM-Atrophy and intestinal metaplasia (IM) as precancerous conditions consistently begin in the antrum and are most severe along the lesser curvature. The aim of this study was to investigate discrepancies in the prevalence, the severity of atrophy, and IM in antral mucosa of Helicobacter pylori infected gastritis and difference in age of onset among Chinese and Dutch patients. METHODS-Two hundred and sixty five Chinese patients and 261 Dutch patients with H pylori infection were enrolled. The degrees of atrophy and IM were graded according to the updated Sydney system. RESULTS-The overall prevalences of atrophy and IM were lower in Dutch patients (42% and 26%, respectively) than in Chinese patients (52% and 32%, respectively). Only the difference in atrophy reached significance (p = 0.028). However, in both Chinese and Dutch patients, the degrees of atrophy and IM were low and severe degrees were rare. The mean ages of Chinese and Dutch patients with atrophy and IM were higher than those without atrophy and IM (with atrophy (Chinese patients): mean, 42.12; SD, 9.80; with IM (Chinese patients): mean, 42.56; SD, 9.96; with atrophy (Dutch patients): mean, 55.16; SD, 12.20; with IM (Dutch patients): mean, 57.79; SD, 11.13; without atrophy (Chinese patients): mean, 39.71; SD, 10.16; without IM (Chinese patients): mean, 40.19; SD, 9.99; without atrophy (Dutch patients): mean, 45.70; SD, 12.44; without IM (Dutch patients): mean, 46.89; SD, 12.68). Atrophy and IM occurred earlier and were more severe in Chinese patients, with both reaching a peak value in patients over 60 years. CONCLUSIONS-There are geographical differences in the prevalence and severity of H pylori infected gastritis, in particular with respect to atrophy and IM, which suggests that infection with H pylori occurs earlier in life and has a higher prevalence in CHINA:
目的——萎缩和肠化生（IM）作为癌前病变，通常始于胃窦，且沿小弯侧最为严重。本研究旨在调查幽门螺杆菌感染性胃炎患者胃窦黏膜中萎缩和IM的患病率、严重程度差异，以及中国和荷兰患者发病年龄的差异。方法——纳入265例中国幽门螺杆菌感染患者和261例荷兰幽门螺杆菌感染患者。根据更新的悉尼系统对萎缩和IM程度进行分级。结果——荷兰患者萎缩和IM的总体患病率（分别为42%和26%）低于中国患者（分别为52%和32%）。仅萎缩程度的差异具有统计学意义（p = 0.028）。然而，中国和荷兰患者的萎缩和IM程度均较低，重度罕见。有萎缩和IM的中国和荷兰患者的平均年龄高于无萎缩和IM的患者（有萎缩（中国患者）：均值42.12；标准差9.80；有IM（中国患者）：均值42.56；标准差9.96；有萎缩（荷兰患者）：均值55.16；标准差12.20；有IM（荷兰患者）：均值57.79；标准差11.13；无萎缩（中国患者）：均值39.71；标准差10.16；无IM（中国患者）：均值40.19；标准差9.99；无萎缩（荷兰患者）：均值45.70；标准差12.44；无IM（荷兰患者）：均值46.89；标准差12.68）。萎缩和IM在中国患者中出现更早且更严重，两者在60岁以上患者中均达到峰值。结论——幽门螺杆菌感染性胃炎的患病率和严重程度存在地域差异，尤其是在萎缩和IM方面，这表明幽门螺杆菌感染在中国人生命中发生更早且患病率更高。
