Department of General Practice, Shijiazhuang City People Hospital, Shijiazhuang, China.
Department of Gastroenterology, Shijiazhuang City People Hospital, Shijiazhuang, China.
Pathobiology. 2021;88(6):383-391. doi: 10.1159/000516855. Epub 2021 Sep 9.
The aim of this study was to study the relationship between the formation of gastric fundic gland polyp and gastric hyperplastic polyp (HP) and the changes of gastric juice microenvironment.
The proton-pump inhibitor (PPI) applications to patients were recorded. Gastric juices and biopsy polyps were collected for pathological examination, H. pylori tests, biomarkers, and MUC1, MUC2, MUC5AC expression measurement.
Among 34,892 patients, the detection rate of gastric fundic gland polyps was significantly higher than that of gastric HPs (p < 0.01). The incidence rate of gastric fundic gland polyp and gastric HP in PPI users (n = 3,886) was higher than that of non-PPI users (p < 0.01). The occurrence of polyp was positively related to the duration of PPI application and the H. pylori-positive rate. The bile reflux rate between fundic gland polys group (17.61%) and HPs (28.67%) was significantly different (p < 0.01). The levels of gastric juice Gastrin-17, epidermal growth factor (EGF) and MUC2 from patients with gastric fundic gland polyps and gastric HPs were higher than those in the control group (p < 0.01). However, patients with gastric fundic gland polyps and HPs had significantly lower gastric juice PGE2 and MUC5AC (p < 0.01).
PPI application, H. pylori infection, and bile reflux are the potential risk factors for formation of fundic gland polyps and HPs. The potential mechanism of polyps' formation can be related to the levels of Gastrin-17, EGF, MUC2, PGE2, and MUC5AC in gastric juice.
本研究旨在探讨胃底腺息肉和增生性胃息肉（HP）的形成与胃液微环境变化之间的关系。
记录质子泵抑制剂（PPI）的应用情况。收集胃液和活检息肉进行病理检查、幽门螺杆菌检测、生物标志物以及 MUC1、MUC2、MUC5AC 表达测定。
在 34892 例患者中，胃底腺息肉的检出率明显高于胃 HP（p<0.01）。PPI 使用者（n=3886）胃底腺息肉和胃 HP 的发生率高于非 PPI 使用者（p<0.01）。息肉的发生与 PPI 应用时间的长短和幽门螺杆菌阳性率呈正相关。胃底腺息肉组（17.61%）和 HP 组（28.67%）之间胆汁反流率差异有统计学意义（p<0.01）。胃底腺息肉和 HP 患者的胃液胃泌素-17、表皮生长因子（EGF）和 MUC2 水平均高于对照组（p<0.01）。然而，胃底腺息肉和 HP 患者的胃液 PGE2 和 MUC5AC 水平显著降低（p<0.01）。
PPI 应用、幽门螺杆菌感染和胆汁反流是胃底腺息肉和 HP 形成的潜在危险因素。息肉形成的潜在机制可能与胃液中胃泌素-17、EGF、MUC2、PGE2 和 MUC5AC 的水平有关。
