胃异型增生可能是结直肠高级别瘤变的独立危险因素。
Gastric dysplasia may be an independent risk factor of an advanced colorectal neoplasm.
机构信息
Department of Internal Medicine, Kyungpook National University Hospital, Chung-Gu, Daegu, South Korea.
出版信息
World J Gastroenterol. 2009 Dec 7;15(45):5722-6. doi: 10.3748/wjg.15.5722.
AIM
To evaluate the relationship between gastric dysplasia and Helicobacter pylori (H pylori) and the occurrence of colorectal adenoma, and to define the necessity for colonoscopy in patients with gastric dysplasia or H pylori infection.
METHODS
From May 2005 to February 2008, 133 patients with established gastric dysplasia by gastroduodenoscopy (EGD) were additionally investigated by colonoscopy. The authors compared results with those of 213 subjects who underwent both EGD and colonoscopy during the same period at the author's Health Promotion Center as a control group. H pylori infection was evaluated in both the gastric dysplasia and control groups.
RESULTS
The mean age of all 346 study subjects was 54.1 +/- 10.5 years, and there were 258 (73%) men and 87 (27%) women. No significant difference was found between the H pylori positive and negative subjects in terms of the prevalence of colorectal adenoma and advanced colorectal adenoma (P = 0.261). Patients with gastric dysplasia showed no elevated risk of colorectal adenoma (OR = 0.910, 95% CI: 0.587-1.411, P = 0.738), but had a significantly higher risk of having advanced colorectal adenoma (OR = 3.382, 95% CI: 1.700-6.342, P = 0.000).
CONCLUSION
The study emphasizes the need for colon surveillance in patients with gastric dysplasia, regardless of H pylori infection.
目的
评估胃黏膜异型增生与幽门螺杆菌（H pylori）感染和结直肠腺瘤发生的关系，明确胃黏膜异型增生或 H pylori 感染患者行结肠镜检查的必要性。
方法
2005 年 5 月至 2008 年 2 月，对经胃镜（EGD）检查确诊的 133 例胃黏膜异型增生患者进行结肠镜检查，将其结果与同期在本单位健康促进中心行 EGD 和结肠镜检查的 213 例患者（对照组）进行比较。所有患者均行 H pylori 感染检测。
结果
346 例研究对象的平均年龄为 54.1±10.5 岁，其中男 258 例（73%），女 87 例（27%）。H pylori 阳性组和阴性组的结直肠腺瘤和进展期结直肠腺瘤的检出率差异均无统计学意义（P=0.261）。胃黏膜异型增生患者发生结直肠腺瘤的风险无显著升高（OR=0.910，95%CI：0.587～1.411，P=0.738），但发生进展期结直肠腺瘤的风险显著升高（OR=3.382，95%CI：1.700～6.342，P=0.000）。
结论
该研究强调，无论是否存在 H pylori 感染，胃黏膜异型增生患者均应行结肠镜检查。
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