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萎缩性胃体胃炎诊断及随访中良性上皮性胃息肉的发生情况及危险因素

Occurrence and risk factors for benign epithelial gastric polyps in atrophic body gastritis on diagnosis and follow-up.

作者信息

Di Giulio E, Lahner E, Micheletti A, Milione M, D'Ambra G, Bordi C, Delle Fave G, Annibale B

机构信息

Digestive and Liver Disease Unit, Second Medical School, University 'La Sapienza', Sant'Andrea Hospital, Rome.

出版信息

Aliment Pharmacol Ther. 2005 Mar 1;21(5):567-74. doi: 10.1111/j.1365-2036.2005.02399.x.

Abstract

BACKGROUND

Benign epithelial gastric polyps have been reported to be more common in atrophic body gastritis. The role of Helicobacter pylori infection in the induction of gastric atrophy is well-known. The development of hyperplastic polyps may be in relation to H. pylori infection.

AIM

To investigate occurrence of benign epithelial gastric polyps in atrophic body gastritis patients at diagnosis and follow-up, and the role of H. pylori and other risk factors for the development of benign epithelial gastric polyps.

METHODS

A total of 259 consecutive atrophic body gastritis patients included in a follow-up programme, of whom 202 were followed up for median period of 4 years (range: 2-11). At baseline and follow-up gastroscopies, the presence of benign epithelial gastric polyps was evaluated. Biopsies for histology were obtained from all detected benign epithelial gastric polyps.

RESULTS

Frequency of benign epithelial gastric polyps in atrophic body gastritis patients were 4.6% at baseline and 5.9% at follow-up. About 91.7% were hyperplastic polyps. H. pylori infection was detected in 79.2% atrophic body gastritis patients with benign epithelial gastric polyps, and in 70.8% without benign epithelial gastric polyps. Smoking was more frequent among patients with benign epithelial gastric polyps [42% vs. 20%, OR 2.8 (95% CI: 1.2-6.9)].

CONCLUSIONS

Benign epithelial gastric polyps occur in about 5% of atrophic body gastritis patients, and the vast majority are hyperplastic polyps. Smoking habit, but not H. pylori infection, increases the risk for benign epithelial gastric polyps in atrophic body gastritis patients.

摘要

背景

据报道,良性上皮性胃息肉在萎缩性胃体炎中更为常见。幽门螺杆菌感染在胃萎缩诱导中的作用是众所周知的。增生性息肉的发生可能与幽门螺杆菌感染有关。

目的

研究萎缩性胃体炎患者在诊断和随访时良性上皮性胃息肉的发生情况,以及幽门螺杆菌和其他危险因素在良性上皮性胃息肉发生中的作用。

方法

共有259例连续纳入随访计划的萎缩性胃体炎患者,其中202例随访中位时间为4年(范围:2 - 11年)。在基线和随访胃镜检查时,评估良性上皮性胃息肉的存在情况。对所有检测到的良性上皮性胃息肉进行组织学活检。

结果

萎缩性胃体炎患者中良性上皮性胃息肉的发生率在基线时为4.6%,随访时为5.9%。约91.7%为增生性息肉。在有良性上皮性胃息肉的萎缩性胃体炎患者中,79.2%检测到幽门螺杆菌感染,在无良性上皮性胃息肉的患者中,70.8%检测到幽门螺杆菌感染。有良性上皮性胃息肉的患者吸烟更为频繁[42%对20%,比值比2.8(95%可信区间:1.2 - 6.9)]。

结论

约5%的萎缩性胃体炎患者发生良性上皮性胃息肉,绝大多数为增生性息肉。吸烟习惯而非幽门螺杆菌感染会增加萎缩性胃体炎患者发生良性上皮性胃息肉的风险。

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