Division of Gastroenterology and Hepatology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan.
Helicobacter. 2021 Dec;26(6):e12845. doi: 10.1111/hel.12845. Epub 2021 Aug 16.
Nodular gastritis is most often one of the manifestations of Helicobacter pylori (H. pylori) infection, which is a risk factor for gastric cancer. This study aimed to determine if the histological characteristics of nodular gastritis differed across classes of age.
We conducted a retrospective analysis of consecutive patients who had undergone esophagogastroduodenoscopy with multiple mucosal biopsies of the stomach between 2003 and 2019 for evaluation of updated Sydney System scores. We analyzed and compared the histological characteristics of pediatric (≤15 years old), young (16-29 years old), and older (≥30 years old) patients.
Of the 1321 patients enrolled, 1027 patients (78%) had H. pylori infection, with 214 patients (21%) of them displaying nodular gastritis. Among nodular gastritis patients, mononuclear cell infiltration Sydney System scores in the gastric body were significantly higher in the older group than in the pediatric (p < .001) and young (p < .001) groups. Similar results were seen for neutrophil infiltration scores in the gastric body. To clarify the characteristics of older nodular gastritis, we investigated 1056 older patients (66 with nodular gastritis, 754 with atrophic gastritis, and 236 H. pylori-negative). The scores for mononuclear and neutrophil cell infiltration in the gastric body were significantly higher in nodular gastritis patients than in atrophic gastritis patients (both p < .001) and patients negative for H. pylori (both p < .001).
The inflammatory changes in the gastric body in older nodular gastritis patients were more severe as compared with those in pediatric and young nodular gastritis patients in addition to older atrophic gastritis patients.
结节性胃炎多为幽门螺杆菌（H. pylori）感染的表现之一，而 H. pylori 感染是胃癌的危险因素。本研究旨在确定结节性胃炎的组织学特征是否因年龄类别而异。
我们对 2003 年至 2019 年间因更新悉尼系统评分而行食管胃十二指肠镜检查并对胃进行多次黏膜活检的连续患者进行了回顾性分析。我们分析并比较了儿科（≤15 岁）、青年（16-29 岁）和老年（≥30 岁）患者的组织学特征。
在纳入的 1321 例患者中，有 1027 例（78%）患有 H. pylori 感染，其中 214 例（21%）患有结节性胃炎。在结节性胃炎患者中，胃体的单个核细胞浸润悉尼系统评分在老年组中明显高于儿科组（p <.001）和青年组（p <.001）。胃体中性粒细胞浸润评分也有类似结果。为了阐明老年结节性胃炎的特征，我们调查了 1056 例老年患者（66 例患有结节性胃炎，754 例患有萎缩性胃炎，236 例 H. pylori 阴性）。胃体的单个核细胞和中性粒细胞浸润评分在结节性胃炎患者中明显高于萎缩性胃炎患者（均 p <.001）和 H. pylori 阴性患者（均 p <.001）。
与儿科和青年结节性胃炎患者以及老年萎缩性胃炎患者相比，老年结节性胃炎患者胃体的炎症变化更为严重。
