Hasegawa Rino, Yao Kenshi, Kanemitsu Takao, Arima Hisatomi, Hirase Takayuki, Hiratsuka Yuuya, Takeda Kazuhiro, Imamura Kentaro, Ohtsu Kensei, Ono Yoichiro, Miyaoka Masaki, Hisabe Takashi, Ueki Toshiharu, Tanabe Hiroshi, Ohta Atsuko, Nimura Satoshi
Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Clin Endosc. 2024 Jan;57(1):65-72. doi: 10.5946/ce.2022.257. Epub 2023 May 9.
BACKGROUND/AIMS: Multiple white and flat elevated lesions (MWFL) that develop from the gastric corpus to the fornix may be strongly associated with oral antacid intake. Therefore, this study aimed to determine the association between the occurrence of MWFL and oral proton pump inhibitor (PPI) intake and clarify the endoscopic and clinicopathological characteristics of MWFL.
The study included 163 patients. The history of oral drug intake was collected, and serum gastrin levels and anti-Helicobacter pylori immunoglobulin G antibody titers were measured. Upper gastrointestinal endoscopy was performed. The primary study endpoint was the association between MWFL and oral PPI intake.
In the univariate analyses, MWFL were observed in 35 (49.3%) of 71 patients who received oral PPIs and 10 (10.9%) of 92 patients who did not receive oral PPIs. The occurrence of MWFL was significantly higher among patients who received PPIs than in those who did not (p<0.001). Moreover, the occurrence of MWFL was significantly higher in patients with hypergastrinemia (p=0.005). In the multivariate analyses, oral PPI intake was the only significant independent factor associated with the presence of MWFL (p=0.001; odds ratio, 5.78; 95% confidence interval, 2.06-16.2).
Our findings suggest that oral PPI intake is associated with the presence of MWFL (UMINCTR 000030144).
背景/目的：从胃体到胃穹窿出现的多个白色扁平隆起性病变（MWFL）可能与口服抗酸剂密切相关。因此，本研究旨在确定MWFL的发生与口服质子泵抑制剂（PPI）之间的关联，并阐明MWFL的内镜及临床病理特征。
本研究纳入了163例患者。收集口服药物史，检测血清胃泌素水平和抗幽门螺杆菌免疫球蛋白G抗体滴度。进行上消化道内镜检查。主要研究终点是MWFL与口服PPI之间的关联。
在单因素分析中，71例接受口服PPI的患者中有35例（49.3%）观察到MWFL，而92例未接受口服PPI的患者中有10例（10.9%）观察到MWFL。接受PPI的患者中MWFL的发生率显著高于未接受PPI的患者（p<0.001）。此外，高胃泌素血症患者中MWFL的发生率显著更高（p=0.005）。在多因素分析中，口服PPI是与MWFL存在相关的唯一显著独立因素（p=0.001；比值比，5.78；95%置信区间，2.06 - 16.2）。
我们的研究结果表明，口服PPI与MWFL的存在有关（UMINCTR 000030144）。
