根除后早期胃癌的内镜表现及相关危险因素探讨

Exploration of endoscopic findings and risk factors of early gastric cancer after eradication of .

机构信息

Endoscopy Center, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.

Department of Gastroenterology and Hepatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.

出版信息

Scand J Gastroenterol. 2021 Mar;56(3):356-362. doi: 10.1080/00365521.2020.1868567. Epub 2021 Jan 7.

DOI:10.1080/00365521.2020.1868567

PMID:33410344

Abstract

AIM

To explore the endoscopic features and risk factors of early gastric cancer (EGC) after eradication of ().

METHODS

A total of 1961 patients who underwent esophago-gastro-duodenoscopy (EGD) with a history of successful eradication were enrolled in this multicenter research. Among them, 162 EGC lesions of 132 patients were detected. The endoscopic features and risk factors of post-eradication EGC were explored.

RESULTS

Severe atrophy (75.3% vs. 16.7%, value <.01), intestinal metaplasia (96.3% vs. 77.1%, value <.01), map-like redness (89.5% vs. 65.4%, value <.01), distinct intermediate zone (IZ) (68.5% vs. 23.4%, value <.01) and xanthoma (58.0% vs. 17.9%, value <.01) were significantly more frequent in the CA group (patients with newly detected EGC after eradication of ) than in the NC group (patients without gastric cancer after eradication of ). In multivariate analysis, severe atrophy (odds ratio (OR) = 8.08; 95% confidence interval (CI), 3.43-20.0; value<.01), map-like redness (OR = 1.75; 95% CI, 0.11-5.25; value = .04), distinct IZ (OR = 2.87; 95% CI, 1.20-6.93; value = .02) and xanthoma (OR = 2.84; 95% CI, 1.20-7.03; value=.02) were proved to be risk factors for detection of EGC after eradication of .

CONCLUSIONS

Severe atrophy and map-like redness and distinct IZ and xanthoma are risk factors of EGC after eradication of .

摘要

目的

探讨（）根除后早期胃癌（EGC）的内镜特征和危险因素。

方法

本多中心研究共纳入 1961 例成功根除（）的患者，行食管胃十二指肠镜检查（EGD）。其中，132 例患者共检出 162 个 EGC 病变。探讨根除后 EGC 的内镜特征和危险因素。

结果

CA 组（根除后新检出胃癌的患者）重度萎缩（75.3% vs. 16.7%，值<0.01）、肠化生（96.3% vs. 77.1%，值<0.01）、地图样红斑（89.5% vs. 65.4%，值<0.01）、明显的中间带（IZ）（68.5% vs. 23.4%，值<0.01）和黄色瘤（58.0% vs. 17.9%，值<0.01）的发生率明显高于 NC 组（根除后无胃癌的患者）。多因素分析显示，重度萎缩（比值比（OR）=8.08；95%置信区间（CI）：3.43-20.0；值<0.01）、地图样红斑（OR=1.75；95%CI：0.11-5.25；值=0.04）、明显的 IZ（OR=2.87；95%CI：1.20-6.93；值=0.02）和黄色瘤（OR=2.84；95%CI：1.20-7.03；值=0.02）是根除后检出 EGC 的危险因素。