Department of Gastroenterology, Henri Mondor University Hospital, APHP, Creteil F-94010, France; Paris Est-Creteil University (UPEC), Creteil F-94010, France; EC2M3-EA7375 Unit, Creteil, France.
Department of Gastroenterology, Henri Mondor University Hospital, APHP, Creteil F-94010, France.
Dig Liver Dis. 2018 Feb;50(2):181-188. doi: 10.1016/j.dld.2017.10.014. Epub 2017 Oct 27.
To evaluate the prevalence and the long-term course of gastric precancerous lesions in patients with GML.
In this retrospective single-centre study, we included 179 patients with GML, 70 with gastric diffuse large B-cell lymphoma (GDLBCL) and 152 with Helicobacter pylori-associated gastritis (HpG), from January 1995 to January 2014. The presence of atrophic gastritis, intestinal metaplasia and neoplastic lesion has been assessed at baseline and during follow-up.
Atrophic gastritis was more frequent in the GML group whereas there was also a trend for intestinal metaplasia and gastric dysplasia. In patients with GML, atrophic gastritis, intestinal metaplasia and gastric dysplasia were more frequent in the GML area than in other part of the stomach. During follow-up, the prevalence of atrophic gastritis remained stable overtime whereas intestinal metaplasia and dysplasia tend to increase overtime. In multivariate analysis, the occurrence of dysplasia or carcinoma was associated with the presence of intestinal metaplasia at baseline and male gender.
GML is associated with gastric precancerous lesion to a higher extent than GDLBCL and HpG. Those precancerous lesions do not regress despite achievement of complete remission of GML and tend to increase overtime.
评估巨大黏膜皱襞(GML)患者胃前病变的发生率及其长期病程。
本回顾性单中心研究纳入了 1995 年 1 月至 2014 年 1 月期间 179 例 GML 患者、70 例胃弥漫性大 B 细胞淋巴瘤(GDLBCL)患者和 152 例幽门螺杆菌相关性胃炎(HpG)患者。基线和随访时评估了萎缩性胃炎、肠上皮化生和肿瘤性病变的存在情况。
GML 组中萎缩性胃炎更为常见,肠上皮化生和胃异型增生也有增加的趋势。在 GML 患者中,GML 区域的萎缩性胃炎、肠上皮化生和胃异型增生比其他胃区更为常见。随访期间,萎缩性胃炎的发生率随时间保持稳定,而肠上皮化生和异型增生则随时间呈增加趋势。多变量分析显示,异型增生或癌的发生与基线时存在肠上皮化生和男性性别有关。
GML 与胃前病变的相关性高于 GDLBCL 和 HpG。尽管 GML 完全缓解,但这些前病变并未消退,且随时间推移呈增加趋势。