Fang Yu, Chen Lei, Chen Dong-Feng, Ren Wan-Ying, Shen Cai-Fei, Xu Yin, Xia Yi-Ju, Li Jing-Wen, Wang Pu, Zhang An-Ran, Shao Shun-Zi, Yu Xiao-Na, Peng Gui-Yong, Fang Dian-Chun
Yu Fang, Lei Chen, Cai-Fei Shen, Yin Xu, Yi-Ju Xia, Jing-Wen Li, Pu Wang, An-Ran Zhang, Shun-Zi Shao, Xiao-Na Yu, Gui-Yong Peng, Dian-Chun Fang, Department of Gastroenterology, Southwest Hospital, The Third Military Medical University, Chongqing 400038, China.
World J Gastroenterol. 2014 Dec 14;20(46):17588-94. doi: 10.3748/wjg.v20.i46.17588.
To determine the prevalence, demographic, clinical and histopathologic features of heterotopic gastric mucosa (HGM) in Chinese patients.
Patients referred to three endoscopy units were enrolled in this study. The macroscopic characteristics of HGM were documented. Biopsies were obtained and observed using hematoxylin and eosin staining. Helicobacter pylori colonization was examined by Whartin-Starry staining.
HGM was observed in 420 Chinese patients, yielding a prevalence of 0.4%. The majority of patients had a single patch (300/420; 71.4%), while the remainder had two (84/420; 20%) or multiple patches (36/420; 8.6%). The size of the patches and the distance from the patch to the frontal incisor teeth varied significantly. The large majority of HGM patches were flat (393/420; 93.6%), whereas the remaining patches were slightly elevated. The primary histological characteristic was fundic-type (216/420; 51.4%) within the HGM patch, and antral- (43/420; 10.2%) and transitional-type (65/420; 15.5%) mucosa were also observed. The prevalence of intestinal metaplasia was 3.1% (13/420) and the prevalence of dysplasia was 1.4% (6/420), indicating the necessity for endoscopic follow-up in patients with HGM. Esophageal and extraesophageal complaints were also observed in patients with HGM. Dysphagia and epigastric discomfort (odds ratios: 6.836 and 115.826, respectively; Ps < 0.05) were independent risk factors for HGM.
Clinical complaints should be considered to improve the detection rate of HMG. The prevalence of intestinal metaplasia and dysplasia also indicates a need for endoscopic follow-up.
确定中国患者异位胃黏膜（HGM）的患病率、人口统计学、临床及组织病理学特征。
本研究纳入了转诊至三个内镜检查科室的患者。记录HGM的宏观特征。获取活检样本并采用苏木精-伊红染色进行观察。通过沃辛-斯塔里染色检查幽门螺杆菌定植情况。
在420名中国患者中观察到HGM，患病率为0.4%。大多数患者有单个病灶（300/420；71.4%），其余患者有两个（84/420；20%）或多个病灶（36/420；8.6%）。病灶大小以及病灶与前门牙的距离差异显著。绝大多数HGM病灶为扁平状（393/420；93.6%），其余病灶略有隆起。HGM病灶内的主要组织学特征为胃底型（216/420；51.4%），同时也观察到胃窦型（43/420；10.2%）和移行型（65/420；15.5%）黏膜。肠化生患病率为3.1%（13/420），发育异常患病率为1.4%（6/420），这表明HGM患者有必要进行内镜随访。HGM患者还出现了食管及食管外症状。吞咽困难和上腹部不适（优势比分别为6.836和115.826；P值<0.05）是HGM的独立危险因素。
应考虑临床症状以提高HMG的检出率。肠化生和发育异常的患病率也表明有必要进行内镜随访。
