非萎缩性胃黏膜是浅表非壶腹十二指肠上皮肿瘤的独立相关因素：一项多中心、匹配的病例对照研究。
Non-atrophic gastric mucosa is an independently associated factor for superficial non-ampullary duodenal epithelial tumors: a multicenter, matched, case-control study.
作者信息
Kawasaki Azusa, Tsuji Kunihiro, Uedo Noriya, Kanesaka Takashi, Miyamoto Hideaki, Gushima Ryosuke, Minoda Yosuke, Ihara Eikichi, Amano Ryosuke, Yao Kenshi, Naito Yoshihide, Aoyagi Hiroyuki, Iwasaki Takehiro, Uchita Kunihisa, Arima Hisatomi, Doyama Hisashi
机构信息
Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan.
Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.
出版信息
Clin Endosc. 2023 Jan;56(1):75-82. doi: 10.5946/ce.2022.059. Epub 2023 Jan 5.
BACKGROUND/AIMS: The etiology of superficial non-ampullary duodenal epithelial tumors (SNADETs) remains unclear. Recent studies have reported conflicting associations between duodenal tumor development and Helicobacter pylori infection or endoscopic gastric mucosal atrophy. As such, the present study aimed to clarify the relationship between SNADETs and H. pylori infection and/or endoscopic gastric mucosal atrophy.
METHODS
This retrospective case-control study reviewed data from 177 consecutive patients with SNADETs who underwent endoscopic or surgical resection at seven institutions in Japan over a three-year period. The prevalence of endoscopic gastric mucosal atrophy and the status of H. pylori infection were compared in 531 sex- and age-matched controls selected from screening endoscopies at two of the seven participating institutions.
RESULTS
For H. pylori infection, 85 of 177 (48.0%) patients exhibited SNADETs and 112 of 531 (21.1%) control patients were non-infected (p<0.001). Non-atrophic mucosa (C0 to C1) was observed in 96 of 177 (54.2%) patients with SNADETs and 112 of 531 (21.1%) control patients (p<0.001). Conditional logistic regression analysis revealed that non-atrophic gastric mucosa was an independent risk factor for SNADETs (odds ratio, 5.10; 95% confidence interval, 2.44-8.40; p<0.001).
CONCLUSION
Non-atrophic gastric mucosa, regardless of H. pylori infection status, was a factor independently associated with SNADETs.
背景/目的：浅表性非壶腹十二指肠上皮肿瘤（SNADETs）的病因尚不清楚。最近的研究报告了十二指肠肿瘤发生与幽门螺杆菌感染或内镜下胃黏膜萎缩之间相互矛盾的关联。因此，本研究旨在阐明SNADETs与幽门螺杆菌感染和/或内镜下胃黏膜萎缩之间的关系。
方法
这项回顾性病例对照研究回顾了在三年期间于日本七家机构接受内镜或手术切除的177例连续性SNADETs患者的数据。从七家参与机构中的两家的筛查内镜检查中选取了531名年龄和性别匹配的对照，比较了内镜下胃黏膜萎缩的患病率和幽门螺杆菌感染状况。
结果
对于幽门螺杆菌感染，177例患者中有85例（48.0%）表现为SNADETs，531例对照患者中有112例（21.1%）未感染（p<0.001）。177例SNADETs患者中有96例（54.2%）观察到非萎缩性黏膜（C0至C1），531例对照患者中有112例（21.1%）（p<0.001）。条件逻辑回归分析显示，非萎缩性胃黏膜是SNADETs的独立危险因素（比值比，5.10；95%置信区间，2.44 - 8.40；p<0.001）。
结论
无论幽门螺杆菌感染状况如何，非萎缩性胃黏膜都是与SNADETs独立相关的一个因素。
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