Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Helicobacter. 2021 Jun;26(3):e12803. doi: 10.1111/hel.12803. Epub 2021 Mar 29.
The Helicobacter pylori (H. pylori) infection-related diseases, peptic ulcer, and gastric cancer are frequently asymptomatic until the onset of complications. This study aimed to investigate the prevalence of H. pylori, erosive esophagitis, peptic ulcer, and precancerous lesions such as atrophic gastritis, intestinal metaplasia, gastric dysplasia, and upper gastrointestinal (GI) malignancy in asymptomatic Chinese.
From January to December 2017, a questionnaire was administered to consecutive asymptomatic patients undergoing routine physical examination, which included their first screening esophagogastroduodenoscopy. H. pylori infection was determined by one of positive C urea breath tests or rapid urease test and histology. The presence of H. pylori infection, erosive esophagitis, peptic ulcer, precancerous gastric histology, and upper GI malignancy was analyzed in relation to demographic factors.
A total of 1108 subjects (mean age: 48, range 21 to 79, 39.5% men) were included. The findings were: erosive esophagitis 7.8%, active H. pylori infection 44%, peptic ulcer 9.1% (duodenal 5.8%, gastric 2.5% or both 0.8%); 0.5% had gastric cancer. Male, smoking history, and current H. pylori infection were all significantly related to the presence of peptic ulcer. Totally, 1095 patients had gastric histopathology and premalignant gastric lesions were present in 67.4%; atrophic gastritis (67.4%), intestinal metaplasia (27.4%), and gastric dysplasia (0.5%). Age, current and previous H. pylori infection were risk factors significantly associated with precancerous lesions.
Upper GI pathology as a sequelae of H. pylori infection is common in asymptomatic Chinese. These findings support institution of a nationwide test and treat program to eradicate H. pylori in China.
幽门螺杆菌（H. pylori）感染相关疾病，如消化性溃疡和胃癌，在出现并发症之前通常无症状。本研究旨在调查无症状中国人群中 H. pylori、糜烂性食管炎、消化性溃疡和癌前病变（如萎缩性胃炎、肠上皮化生、胃上皮异型增生和上消化道（GI）恶性肿瘤）的流行情况。
2017 年 1 月至 12 月，对接受常规体检的连续无症状患者进行问卷调查，其中包括首次筛查性食管胃十二指肠镜检查。通过 13C 尿素呼气试验或快速尿素酶试验和组织学检查确定 H. pylori 感染。分析 H. pylori 感染、糜烂性食管炎、消化性溃疡、胃癌前组织学和上消化道恶性肿瘤与人口统计学因素的关系。
共纳入 1108 例患者（平均年龄 48 岁，范围 21-79 岁，39.5%为男性）。结果发现：糜烂性食管炎 7.8%，活动性 H. pylori 感染 44%，消化性溃疡 9.1%（十二指肠溃疡 5.8%，胃溃疡 2.5%或两者均有 0.8%）；0.5%患有胃癌。男性、吸烟史和现症 H. pylori 感染均与消化性溃疡的发生显著相关。1095 例患者进行了胃组织病理学检查，癌前病变的发生率为 67.4%；萎缩性胃炎（67.4%）、肠上皮化生（27.4%）和胃上皮异型增生（0.5%）。年龄、现症和既往 H. pylori 感染是与癌前病变显著相关的危险因素。
上消化道疾病是 H. pylori 感染的后遗症，在中国无症状人群中较为常见。这些发现支持在中国实施全国性的检测和治疗方案以根除 H. pylori。
