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中国自身免疫性化生萎缩性胃炎:一项在大型三级医疗中心对320例患者的研究

Autoimmune metaplastic atrophic gastritis in chinese: a study of 320 patients at a large tertiary medical center.

作者信息

Zhang Hejun, Jin Zhu, Cui Rongli, Ding Shigang, Huang Yonghui, Zhou Liya

机构信息

a Pathological Laboratory, Department of Gastroenterology , Beijing Key Laboratory for Helicobacter pylori Infection and Upper Gastrointestinal Diseases, Peking University Third Hospital , Beijing , PR China.

出版信息

Scand J Gastroenterol. 2017 Feb;52(2):150-156. doi: 10.1080/00365521.2016.1236397. Epub 2016 Sep 27.

Abstract

OBJECTIVES

Autoimmune metaplastic atrophic gastritis (AMAG) is an uncommon disease worldwide and may predispose to gastric carcinoid tumors or adenocarcinomas. The aims of this study were to outline the clinical characteristics of Chinese AMAG patients, including demographic pattern, hematologic features, and gastroscopic and histopathologic findings.

PATIENTS AND METHODS

A total of 320 Chinese patients with AMAG, from January 2007 to December 2014, were reviewed in a regional hospital of China.

RESULTS

Of the 320 AMAG patients, the mean age was 60.6 ± 12.3 years [range 26-86; 206 (64.4%) women]. The coarse annual detection rate was 0.9%. Anemia was present in only 19.3% patients (53/275) and 3.5% (11/315) AMAG patients also had primary biliary cirrhosis. One hundred and thirty-six had endoscopically identifiable lesions. These lesions consisted of 130 polypoid lesions (63 hyperplastic polyps, 2 oxyntic mucosa pseudopolyps, 2 intestinal-type gastric adenomas, 2 fundic gland polyps, 5 concurrent polyps, 14 well-differentiated neuroendocrine neoplasms, 7 submucosal tumors and 35 chronic gastritis), 6 adenocarcinomas. The detection rate of atrophy and intestinal metaplasia in antral mucosa were 47.2 and 37.5%, respectively.

CONCLUSIONS

AMAG is more frequent than expected in China and display a female predominance, accompanied with other autoimmune disorders. AMAG should be paid more attention by clinicians through a multidisciplinary team approach.

摘要

目的

自身免疫性化生萎缩性胃炎(AMAG)在全球范围内是一种罕见疾病,可能易患胃类癌肿瘤或腺癌。本研究的目的是概述中国AMAG患者的临床特征,包括人口统计学模式、血液学特征以及胃镜和组织病理学检查结果。

患者与方法

对2007年1月至2014年12月期间中国一家地区医院的320例中国AMAG患者进行了回顾性研究。

结果

在320例AMAG患者中,平均年龄为60.6±12.3岁[范围26 - 86岁;206例(64.4%)为女性]。粗略的年检出率为0.9%。仅19.3%的患者(53/275)存在贫血,3.5%(11/315)的AMAG患者还患有原发性胆汁性肝硬化。136例患者有内镜可识别的病变。这些病变包括130个息肉样病变(63个增生性息肉、2个胃体黏膜假息肉、2个肠型胃腺瘤、2个胃底腺息肉、5个并发息肉、14个高分化神经内分泌肿瘤、7个黏膜下肿瘤和35个慢性胃炎)、6例腺癌。胃窦黏膜萎缩和肠化生的检出率分别为47.2%和37.5%。

结论

AMAG在中国比预期更为常见,以女性为主,伴有其他自身免疫性疾病。临床医生应通过多学科团队方法对AMAG给予更多关注。

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