State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, Shaanxi Province, China.
Department of Gastroenterology, Air Force Hospital of Northern Theater of PLA, Shenyang, Liaoning Province, China.
J Dig Dis. 2021 May;22(5):282-290. doi: 10.1111/1751-2980.12986. Epub 2021 May 6.
To identify whether bile reflux on endoscopy and other related variables are risk factors for precancerous gastric lesions and gastric cancer (GC).
A multicenter, cross-sectional and observational study was conducted in five centers in China from June to October 2019, 1162 patients were recruited and divided into the chronic gastritis (CG), the precancerous lesion (low-grade intraepithelial neoplasia and intestinal metaplasia), and GC groups (including high-grade intraepithelial neoplasia). All participants underwent detailed interviews, endoscopy and biopsy, and completed questionnaires. Odds ratio and 95% confidence interval were calculated with multivariate logistic regression models with or without adjustment for Helicobacter pylori infection.
We recruited 668 patients with CG, 411 with precancerous lesions and 83 with GC. By comparing the CG and precancerous lesion groups, independent risk factors for cancerous gastric lesions were the grade of bile reflux, patient's age, dietary habits and family history of GC. Similar results were obtained when comparing the CG and GC groups. In addition, bile reflux was confirmed as an independent risk factor for progression from precancerous lesions to cancer.
Bile reflux on endoscopy as well as age, dietary habits and a family history of GC were independent risk factors for the development of precancerous gastric lesions and GC.
确定内镜下胆汁反流和其他相关变量是否为胃癌前病变和胃癌（GC）的危险因素。
本研究为 2019 年 6 月至 10 月在中国五家中心进行的多中心、横断面和观察性研究，共招募了 1162 名患者，分为慢性胃炎（CG）、癌前病变（低级别上皮内瘤变和肠化生）和 GC 组（包括高级别上皮内瘤变）。所有参与者均接受详细的访谈、内镜和活检，并完成问卷。使用多变量逻辑回归模型计算比值比（OR）和 95%置信区间（CI），并分别进行了调整和未调整幽门螺杆菌感染的分析。
本研究共纳入了 668 例 CG 患者、411 例癌前病变患者和 83 例 GC 患者。与 CG 组和癌前病变组相比，癌症胃病变的独立危险因素为胆汁反流程度、患者年龄、饮食习惯和 GC 家族史。在 CG 组和 GC 组之间也得到了相似的结果。此外，胆汁反流被证实是从癌前病变进展为癌症的独立危险因素。
内镜下胆汁反流以及年龄、饮食习惯和 GC 家族史是胃癌前病变和 GC 发生的独立危险因素。
