通过双对比上消化道钡剂X线造影诊断的萎缩性胃炎和胃皱襞增大，基于3年的前瞻性观察，有助于预测未来胃癌的发生。
Atrophic gastritis and enlarged gastric folds diagnosed by double-contrast upper gastrointestinal barium X-ray radiography are useful to predict future gastric cancer development based on the 3-year prospective observation.
作者信息
Yamamichi Nobutake, Hirano Chigaya, Ichinose Masao, Takahashi Yu, Minatsuki Chihiro, Matsuda Rie, Nakayama Chiemi, Shimamoto Takeshi, Kodashima Shinya, Ono Satoshi, Tsuji Yosuke, Niimi Keiko, Sakaguchi Yoshiki, Kataoka Yosuke, Saito Itaru, Asada-Hirayama Itsuko, Takeuchi Chihiro, Yakabi Seiichi, Kaikimoto Hikaru, Matsumoto Yuta, Yamaguchi Daisuke, Kageyama-Yahara Natsuko, Fujishiro Mitsuhiro, Wada Ryoichi, Mitsushima Toru, Koike Kazuhiko
机构信息
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Kameda Medical Center Makuhari, CD-2, 1-3, Nakase, Mihama-ku, Chiba, 261-0023, Japan.
出版信息
Gastric Cancer. 2016 Jul;19(3):1016-22. doi: 10.1007/s10120-015-0558-0. Epub 2015 Oct 20.
BACKGROUND
Double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) is the standard gastric cancer screening method in Japan. Atrophic gastritis and enlarged gastric folds are considered the two major features of Helicobacter pylori-induced chronic gastritis, but the clinical meaning of evaluating them by UGI-XR has not been elucidated.
METHODS
We analyzed healthy UGI-XR examinees without a history of gastrectomy, previous Helicobacter pylori eradication and usage of gastric acid suppressants.
RESULTS AND CONCLUSIONS
Of the 6433 subjects, 1936 (30.1 %) had atrophic gastritis and 1253 (19.5 %) had enlarged gastric folds. During the 3-year prospective observational follow-up, gastric cancer developed in seven subjects, six of whom (85.7 %) had atrophic gastritis with H. pylori infection and five of whom (71.4 %) had enlarged gastric folds with H. pylori infection. The Kaplan-Meier method with log-rank testing revealed that both UGI-XR-based atrophic gastritis (p = 0.0011) and enlarged gastric folds (p = 0.0003) are significant predictors for future gastric cancer incidence.
背景
双重对比上消化道钡剂X线造影（UGI-XR）是日本胃癌筛查的标准方法。萎缩性胃炎和胃皱襞增大被认为是幽门螺杆菌引起的慢性胃炎的两个主要特征，但通过UGI-XR评估它们的临床意义尚未阐明。
方法
我们分析了无胃切除术史、既往未根除幽门螺杆菌且未使用胃酸抑制剂的健康UGI-XR检查者。
结果与结论
在6433名受试者中，1936名（30.1%）有萎缩性胃炎，1253名（19.5%）有胃皱襞增大。在3年的前瞻性观察随访中，7名受试者发生了胃癌，其中6名（85.7%）有幽门螺杆菌感染的萎缩性胃炎，5名（71.4%）有幽门螺杆菌感染的胃皱襞增大。采用对数秩检验的Kaplan-Meier方法显示，基于UGI-XR的萎缩性胃炎（p = 0.0011）和胃皱襞增大（p = 0.0003）都是未来胃癌发病率的重要预测指标。
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