Badmos K B, Ojo O S, Olasode B J, Arigbabu A O
Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State. Nigeria.
Niger Postgrad Med J. 2012 Jun;19(2):92-6.
To investigate the frequency of precancerous lesions in H. pylori gastritis in Nigerians
Previously, the slides of all endoscopic gastroduodenal biopsies seen at the Pathology Department of Obafemi Awolowo University Teaching Hospital, Ile-Ife between 1994 and 2003 were reviewed and published. The current review examined interplay of intestinal metaplasia, glandular atrophy and epithelial dysplasia with H.pylori. The H.pylori, intestinal metaplasia and glandular atrophy were graded based on updated Sydney classification scheme while Vienna classification was used for dysplasia.
Out of 1036 biopsies seen during the study period, 135 (13%) had associated precancerous lesions. Intestinal metaplasia was the commonest (9.2%), followed by severe atrophic gastritis (4.3%) and low grade dysplasia (0.7%) occurring either alone or in various combinations. Most of these lesions were seen in patients above 40 years of age and over 80% were H.pylori positive.
Frequency of precancerous lesions is low among Nigerians with H.pylori gastritis. Intestinal metaplasia was the commonest lesion and was mostly type I with relatively low risk for gastric cancer development. The relatively high prevalence H.pylori infection among these cases could have resulted from repeated infection and most were localised to the corpus relative to the antral region where the precancerous lesions were seen.
调查尼日利亚人幽门螺杆菌胃炎癌前病变的发生率
此前，已对1994年至2003年间在伊莱-伊费奥巴费米·阿沃洛沃大学教学医院病理科所见的所有内镜下胃十二指肠活检切片进行了回顾并发表。本次回顾研究了肠化生、腺体萎缩和上皮发育异常与幽门螺杆菌之间的相互作用。幽门螺杆菌、肠化生和腺体萎缩根据更新后的悉尼分类方案进行分级，而发育异常则采用维也纳分类。
在研究期间所见的1036例活检中，135例（13%）伴有癌前病变。肠化生最为常见（9.2%），其次是重度萎缩性胃炎（4.3%）和低级别发育异常（0.7%），这些病变可单独出现或多种组合出现。这些病变大多见于40岁以上患者，超过80%的患者幽门螺杆菌呈阳性。
尼日利亚幽门螺杆菌胃炎患者的癌前病变发生率较低。肠化生是最常见的病变，大多为I型，胃癌发生风险相对较低。这些病例中幽门螺杆菌感染率相对较高可能是由于反复感染，且相对于出现癌前病变的胃窦区域，大多数感染局限于胃体部。
