Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
Department of Internal Medicine, Moriguchi Keijinkai Hospital, Moriguchi, Osaka, Japan.
BMC Gastroenterol. 2020 Nov 23;20(1):396. doi: 10.1186/s12876-020-01545-z.
There are often specific endoscopic findings caused by deposition of lanthanum (La) in the gastric mucosa of patients taking lanthanum carbonate (LaC), a novel phosphate binder for patients on hemodialysis. We conducted a retrospective study to investigate the clinical significance of La deposition in the gastric mucosa, and the association between endoscopic features and histologic findings in the same population.
We compared background factors in patients taking LaC with and without La deposition in their gastroscopic biopsy specimen. We also investigated the relationship between gastric endoscopic biopsy specimens with La deposition and the concurrent endoscopic images.
There was a significant difference in the total dose of LaC between the La-positive and La-negative groups (990 g [180-3150 g] vs. 480 g [225-1328 g]; p = 0.013). In 27 biopsy specimens with specific whitish mucosa, 10 showed mild histiocytic infiltration and 17 showed severe infiltration. In contrast, among 24 specimens with non-whitish mucosa, 5 showed no histiocytic infiltration, 10 showed mild infiltration, and 9 showed severe infiltration. There was a significant relationship between endoscopic features and the degree of histiocytic infiltration (p = 0.026).
We demonstrated that La deposition in the gastric mucosa depended on the total dose of LaC and was not affected by background factors. The specific endoscopic features of La deposition are associated with the infiltration of histiocytes, which represents the body's normal response to foreign bodies. Trial registry The protocol was registered in the University Hospital Medical Information Network Clinical Trial Registry (UMIN000038929, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000044393 ).
服用碳酸镧（LaC）的患者胃黏膜中镧（La）沉积常导致特定的内镜表现，LaC 是一种新型的血液透析患者磷结合剂。我们进行了一项回顾性研究，旨在探讨胃黏膜中 La 沉积的临床意义，以及同一人群内镜表现与组织学发现之间的关系。
我们比较了胃活检标本中存在和不存在 La 沉积的 LaC 服用者的背景因素。我们还研究了伴有 La 沉积的胃内镜活检标本与同期内镜图像之间的关系。
La 阳性组和 La 阴性组的 LaC 总剂量有显著差异（990 g [180-3150 g] vs. 480 g [225-1328 g]；p = 0.013）。在 27 例具有特定白色黏膜的活检标本中，10 例显示轻度组织细胞浸润，17 例显示重度浸润。相比之下，在 24 例非白色黏膜标本中，5 例无组织细胞浸润，10 例轻度浸润，9 例重度浸润。内镜特征与组织细胞浸润程度之间存在显著关系（p = 0.026）。
我们证明胃黏膜中的 La 沉积取决于 LaC 的总剂量，不受背景因素的影响。La 沉积的特定内镜特征与组织细胞浸润有关，这代表了机体对异物的正常反应。试验注册 该方案在大学医院医疗信息网络临床试验注册（UMIN000038929，https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000044393）中注册。
