Leodolter Andreas, Ebert Matthias P, Peitz Ulrich, Wolle Kathlen, Kahl Stefan, Vieth Michael, Malfertheiner Peter
Department of Gastroenterology and Hepatology, Otto-von-Guericke University, Leipziger Street 44, Magdeburg D-39120, Germany.
World J Gastroenterol. 2006 Sep 14;12(34):5509-12. doi: 10.3748/wjg.v12.i34.5509.
To investigate the prevalence of H pylori associated corpus-predominant gastritis (CPG) or pangastritis, severe atrophy, and intestinal metaplasia (IM) in patients without any significant abnormal findings during upper-GI endoscopy.
Gastric biopsies from 3548 patients were obtained during upper GI-endoscopy in a 4-year period. Two biopsies from antrum and corpus were histologically assessed according to the updated Sydney-System. Eight hundred and forty-five patients (mean age 54.8 +/- 2.8 years) with H pylori infection and no peptic ulcer or abnormal gross findings in the stomach were identified and analyzed according to gastritis phenotypes using different scoring systems.
The prevalence of severe H pylori associated changes like pangastritis, CPG, IM, and severe atrophy increased with age, reaching a level of 20% in patients of the age group over 45 years. No differences in frequencies between genders were observed. The prevalence of IM had the highest increase, being 4-fold higher at the age of 65 years versus in individuals less than 45 years.
The prevalence of gastritis featuring at risk for cancer development increases with age. These findings reinforce the necessity for the histological assessment, even in subjects with normal endoscopic appearance. The age-dependent increase in prevalence of severe histopathological changes in gastric mucosa, however, does not allow estimating the individual risk for gastric cancer development--only a proper follow-up can provide this information.
调查在上消化道内镜检查中无任何显著异常发现的患者中幽门螺杆菌相关性胃体为主型胃炎（CPG）或全胃炎、严重萎缩及肠化生（IM）的患病率。
在4年期间对上消化道内镜检查的3548例患者进行胃活检。根据更新后的悉尼系统对取自胃窦和胃体的两块活检组织进行组织学评估。确定845例幽门螺杆菌感染且无消化性溃疡或胃部肉眼异常发现的患者（平均年龄54.8±2.8岁），并使用不同评分系统根据胃炎表型进行分析。
幽门螺杆菌相关性严重改变如全胃炎、CPG、IM和严重萎缩的患病率随年龄增加，在45岁以上年龄组患者中达到20%的水平。未观察到性别之间在频率上的差异。IM的患病率增加最高，65岁时比45岁以下个体高4倍。
具有癌症发生风险的胃炎患病率随年龄增加。这些发现强化了即使在内镜外观正常的受试者中进行组织学评估的必要性。然而，胃黏膜严重组织病理学改变患病率的年龄依赖性增加并不能估计个体患胃癌的风险——只有适当的随访才能提供此信息。
