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根除前后与胃癌发生相关的结节性胃炎

Nodular gastritis in association with gastric cancer development before and after eradication.

作者信息

Nishikawa Izumi, Kato Jun, Terasoma Satoshi, Matsutani Hiroyoshi, Tamaki Hidehiko, Tamaki Tetsuya, Kuwashima Fumiaki, Nakata Hiroya, Tomeki Tatsuji, Matsunaka Hideyuki, Ibata Yumiko, Yamashita Yasunobu, Maekita Takao, Higashi Katsuhiko, Ichinose Masao

机构信息

First Department of Internal Medicine Hidaka General Hospital Wakayama Japan.

Second Department of Internal Medicine Wakayama Medical University Wakayama Japan.

出版信息

JGH Open. 2018 Mar 25;2(3):80-86. doi: 10.1002/jgh3.12049. eCollection 2018 Jun.

Abstract

BACKGROUND AND AIM

Nodular gastritis is caused by infection and is associated with the development of diffuse-type gastric cancer. This study examined the clinical characteristics of patients with nodular gastritis, including cancer incidence before and after H. pylori eradication.

METHODS

This was a retrospective study of patients who underwent upper endoscopy and were positive for H. pylori infection. We examined the clinical findings and follow-up data after H. pylori eradication in patients with and without nodular gastritis.

RESULTS

Of the 674 patients with H. pylori infections, nodular gastritis was observed in 114 (17%). It was more prevalent in women (69%) and young adults. Among patients with nodular gastritis, six (5%) had gastric cancer, all of which were of the diffuse type. Among the 19 (4%) patients with gastric cancer and no nodular gastritis, 16 had intestinal-type cancer. White spot aggregates in the corpus, a specific finding in patients with nodular gastritis, were more frequently observed in patients with gastric cancer than in those without (83% 26%,  = 0.0025). Of 82 patients with nodular gastritis who had H. pylori eradicated successfully, none developed gastric cancer over a 3-year follow-up period, while 7 (3%) of 220 patients without nodular gastritis developed gastric cancer after H. pylori eradication.

CONCLUSIONS

In patients with nodular gastritis, white spot aggregates in the corpus may indicate a higher risk of developing diffuse-type gastric cancer. Nodular gastritis may be an indication for eradication therapy to reduce the risk of cancer development after H. pylori eradication.

摘要

背景与目的

结节性胃炎由感染引起,与弥漫型胃癌的发生有关。本研究探讨了结节性胃炎患者的临床特征,包括幽门螺杆菌根除前后的癌症发病率。

方法

这是一项对接受上消化道内镜检查且幽门螺杆菌感染呈阳性患者的回顾性研究。我们检查了有或无结节性胃炎患者在幽门螺杆菌根除后的临床发现和随访数据。

结果

在674例幽门螺杆菌感染患者中,114例(17%)观察到结节性胃炎。其在女性(69%)和年轻人中更为普遍。在结节性胃炎患者中,6例(5%)患有胃癌,均为弥漫型。在19例(4%)无结节性胃炎的胃癌患者中,16例为肠型癌。胃体部的白斑聚集是结节性胃炎患者的一个特定表现,在胃癌患者中比无胃癌患者更频繁地观察到(83%对26%,P = 0.0025)。在82例成功根除幽门螺杆菌的结节性胃炎患者中,在3年随访期内无一人发生胃癌,而在220例无结节性胃炎的患者中,7例(3%)在幽门螺杆菌根除后发生了胃癌。

结论

在结节性胃炎患者中,胃体部的白斑聚集可能表明发生弥漫型胃癌的风险较高。结节性胃炎可能是根除治疗的一个指征,以降低幽门螺杆菌根除后癌症发生的风险。

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