Hasegawa Rino, Yao Kenshi, Ihara Shoutomi, Miyaoka Masaki, Kanemitsu Takao, Chuman Kenta, Ikezono Go, Hirano Akikazu, Ueki Toshiharu, Tanabe Hiroshi, Ota Atsuko, Haraoka Seiji, Iwashita Akinori
Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Department of Cardiology, Iharakasuga Clinic, Fukuoka, Japan.
Clin Endosc. 2018 Nov;51(6):558-562. doi: 10.5946/ce.2018.104. Epub 2018 Nov 21.
BACKGROUND/AIMS: While the occurrence of multiple whitish flat elevated lesions (MWFL) was first reported in 2007, no studies on MWFL have been published to date. The present retrospective observational study aimed to clarify the endoscopic findings and clinicopathological features of MWFL.
Subjects were consecutive patients who underwent upper gastrointestinal endoscopy as part of routine screening between April 2014 and March 2015. The conventional white-light, non-magnifying and magnifying narrow-band images were reviewed. Clinical features were compared between patients with and without MWFL.
The conventional endoscopic findings of MWFL include multiple whitish, flat, and slightly elevated lesions of various sizes, mainly located in the gastric body and fundus. Narrow-band imaging enhanced the contrast of MWFL and background mucosa, and magnifying narrow-band imaging depicted a uniformly long, narrow, and elliptical marginal crypt epithelium with an unclear microvascular pattern. Histopathological findings revealed hyperplastic changes of the foveolar epithelium, and parietal cell protrusions and oxyntic gland dilatations were observed in the fundic glands, without any intestinal metaplasia. The rate of acid-reducing drug use was significantly higher in patients with MWFL than in those without (100% [13/13] vs. 53.7% [88/164], p<0.001).
The present study indicated a relationship between the presence and endoscopic features of MWFL and history of acidreducing drug use.
背景/目的：虽然多个白色扁平隆起性病变（MWFL）于2007年首次被报道，但迄今为止尚未发表关于MWFL的研究。本回顾性观察研究旨在阐明MWFL的内镜表现和临床病理特征。
研究对象为2014年4月至2015年3月期间作为常规筛查一部分接受上消化道内镜检查的连续患者。对传统白光、非放大和放大窄带图像进行了回顾。比较了有和没有MWFL的患者的临床特征。
MWFL的传统内镜表现包括多个大小各异的白色、扁平且略隆起的病变，主要位于胃体和胃底。窄带成像增强了MWFL与背景黏膜的对比度，放大窄带成像显示边缘隐窝上皮呈均匀的长、窄且椭圆形，微血管形态不清晰。组织病理学结果显示小凹上皮增生，胃底腺可见壁细胞突起和泌酸腺扩张，无任何肠化生。MWFL患者使用抑酸药物的比例显著高于无MWFL的患者（100% [13/13] 对53.7% [88/164]，p<0.001）。
本研究表明MWFL的存在、内镜特征与抑酸药物使用史之间存在关联。
