Department of Gastroenterology and Hepatology, Sapporo Medical University, Sapporo, Japan.
Department of Gastroenterology, Otaru General Hospital, Otaru, Japan.
Gut Liver. 2019 Mar 15;13(4):409-414. doi: 10.5009/gnl17136.
BACKGROUND/AIMS: Fundic gland polyps (FGPs), hyperplastic polyps (HPs), and xanthomas (XTs) are common benign gastric lesions that can be diagnosed by endoscopic appearance alone in most cases. The aim of this study was to evaluate associations between gastric cancer and these benign lesions.
Two expert endoscopists reviewed a series of gastroscopy images. FGPs, HPs, and XTs were diagnosed by endoscopic appearance, whereas all gastric cancers were confirmed pathologically.
Of the 1,227 patients reviewed, 114 (9.3%) had a concurrent or past history of gastric cancer. The overall prevalences of FGPs, HPs and XTs were 9.4%, 6.3% and 14.2%, respectively. HPs and XTs coexisted in 1.6% of patients, whereas other combinations were rarer. XTs were observed in 39.3% and 11.5% of patients with and without gastric cancer, respectively (p<0.001). In contrast, no gastric cancer patients had FGPs, whereas 10.4% of patients without cancer had FGPs (p<0.001). The prevalence of HPs was similar between the two groups (8.8% and 6.0% of patients with and without cancer, respectively, p=0.29). Multivariate and Mantel-Haenszel analyses demonstrated that XTs were positively associated and FGPs were negatively associated with gastric cancer.
XTs and FGPs might be useful as endoscopic risk indicators for monitoring gastric cancer.
背景/目的：胃底腺息肉（FGPs）、增生性息肉（HPs）和黄斑瘤（XTs）是常见的良性胃病变，在大多数情况下仅通过内镜表现即可诊断。本研究旨在评估这些良性病变与胃癌之间的关联。
两名专家内镜医师回顾了一系列胃镜图像。FGPs、HPs 和 XTs 通过内镜表现诊断，而所有胃癌均经病理证实。
在回顾的 1227 名患者中，有 114 名（9.3%）同时或既往患有胃癌。FGPs、HPs 和 XTs 的总体患病率分别为 9.4%、6.3%和 14.2%。HPs 和 XTs 同时存在于 1.6%的患者中，而其他组合则较少见。XTs 在胃癌患者和无胃癌患者中的发生率分别为 39.3%和 11.5%（p<0.001）。相比之下，没有胃癌患者有 FGPs，而无癌症患者中有 10.4%有 FGPs（p<0.001）。两组患者的 HPs 患病率相似（胃癌患者和无胃癌患者分别为 8.8%和 6.0%，p=0.29）。多变量和 Mantel-Haenszel 分析表明，XTs 与胃癌呈正相关，FGPs 与胃癌呈负相关。
XTs 和 FGPs 可能作为监测胃癌的内镜风险指标有用。
