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根除治疗后发生多发胃癌患者的京都分类

Kyoto classification in patients who developed multiple gastric carcinomas after eradication.

作者信息

Sakitani Kosuke, Nishizawa Toshihiro, Toyoshima Akira, Yoshida Shuntaro, Matsuno Tatsuya, Yamada Tomoharu, Irokawa Masatoshi, Takahashi Yoshiyuki, Nakai Yousuke, Toyoshima Osamu, Koike Kazuhiko

机构信息

Department of Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan.

Department of Colorectal Surgery, Japanese Red Cross Medical Center, Tokyo 150-8935, Japan.

出版信息

World J Gastrointest Endosc. 2020 Sep 16;12(9):276-284. doi: 10.4253/wjge.v12.i9.276.

Abstract

BACKGROUND

Endoscopic Kyoto classification predicts gastric cancer risk; however, the score in the patients with primary gastric cancer after () eradication therapy is unknown.

AIM

To elucidate the Kyoto classification score in patients with both single gastric cancer and multiple gastric cancers developed after eradication.

METHODS

The endoscopist recorded the Kyoto classification at the endoscope and the Kyoto classification score at the time of the first diagnosis of gastric cancer after eradication. The score was compared between single gastric cancer group and multiple gastric cancers group.

RESULTS

The Kyoto score at the time of diagnosis of 45 cases of gastric cancer after eradication was 4.0 points in average. The score was 3.8 points in the single gastric cancer group, and 5.1 points in the multiple gastric cancers group. The multiple group had a significantly higher score than the single group ( = 0.016). In the multiple gastric cancers group, all the patients (7/7) had 5 or higher Kyoto score, while in single gastric cancer group, the proportion of patients with a score of 5 or higher was less than half, or 44.7% (17/38).

CONCLUSION

Patients diagnosed with gastric cancer after eradication tended to have advanced gastritis. In particular, in cases of multiple gastric cancers developed after eradication, the endoscopic Kyoto classification score tended to be 5 or higher in patients with an open type atrophic gastritis and the intestinal metaplasia extended to the corpus.

摘要

背景

内镜京都分类可预测胃癌风险;然而,根除治疗后原发性胃癌患者的评分尚不清楚。

目的

阐明根除治疗后发生单发性胃癌和多发性胃癌患者的京都分类评分。

方法

内镜医师记录内镜检查时的京都分类以及根除治疗后首次诊断为胃癌时的京都分类评分。比较单发性胃癌组和多发性胃癌组的评分。

结果

根除治疗后45例胃癌患者诊断时的京都评分平均为4.0分。单发性胃癌组评分为3.8分,多发性胃癌组评分为5.1分。多发性胃癌组评分显著高于单发性胃癌组(P = 0.016)。在多发性胃癌组中,所有患者(7/7)京都评分≥5,而在单发性胃癌组中,评分≥5的患者比例不到一半,为44.7%(17/38)。

结论

根除治疗后诊断为胃癌的患者往往患有进展期胃炎。特别是,在根除治疗后发生多发性胃癌的病例中,开放性萎缩性胃炎且肠化生扩展至胃体的患者内镜京都分类评分往往≥5。

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