Health Center, Shimane Environment and Health Public Corporation, Japan.
Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan.
Intern Med. 2024 Aug 15;63(16):2251-2258. doi: 10.2169/internalmedicine.2955-23. Epub 2024 Jan 13.
Objective This study investigated the prevalence of gastric epithelial tumor in Helicobacter pylori-uninfected subjects who underwent esophagogastroduodenoscopy (EGD) as part of an annual checkup. Methods A total of 20,540 EGD examinations of H. pylori-uninfected individuals (12,917 men, 7,623 women; mean age 51.5±9.2 years old) were performed between April 2016 and March 2023. The prevalence of gastric epithelial tumor discovery and the size and location of each lesion type were analyzed. Results According to 20,540 examinations, 61 gastric epithelial tumors were endoscopically and histologically diagnosed in 58 of the subjects, with a prevalence rate of 0.28%. These tumors included signet-ring carcinoma (n=10, 0.05%), gastric adenocarcinoma of fundic-gland type (n=10, 0.05%), intestinal-type well-differentiated adenocarcinoma (n=2, 0.01%), and raspberry-type gastric foveolar tumors (n=36, 0.18%). One subject had two intestinal-type well-differentiated adenocarcinomas, and two each had two raspberry-type gastric foveolar tumors. The mean sizes of the signet-ring carcinomas, gastric adenocarcinoma of fundic-gland type, intestinal-type well-differentiated adenocarcinomas, and raspberry-type gastric foveolar tumors were 6.4, 4.7, 5.0, and 3.4 mm, respectively. Each lesion was located at a specific site in the stomach characteristic of its type. Conclusion In the present H. pylori-uninfected subjects, the prevalence of gastric epithelial tumors found on an EGD examination was 0.28%. Endoscopic examination should be performed in H. pylori-uninfected individuals to detect such tumors in characteristic locations.
目的 本研究旨在调查在接受年度体检行食管胃十二指肠镜检查（EGD）的未感染幽门螺杆菌的个体中胃上皮肿瘤的发生率。
方法 2016 年 4 月至 2023 年 3 月期间，对 20540 例未感染幽门螺杆菌的个体（男性 12917 例，女性 7623 例；平均年龄 51.5±9.2 岁）进行了 EGD 检查。分析了胃上皮肿瘤发现的发生率以及每种病变类型的大小和位置。
结果 根据 20540 例检查，在 58 例患者中经内镜和组织学诊断出 61 例胃上皮肿瘤，发生率为 0.28%。这些肿瘤包括印戒细胞癌（n=10，0.05%）、胃底腺型胃腺癌（n=10，0.05%）、肠型高分化腺癌（n=2，0.01%）和覆盆子型胃小凹肿瘤（n=36，0.18%）。1 例患者有 2 例肠型高分化腺癌，2 例患者各有 2 例覆盆子型胃小凹肿瘤。印戒细胞癌、胃底腺型胃腺癌、肠型高分化腺癌和覆盆子型胃小凹肿瘤的平均大小分别为 6.4、4.7、5.0 和 3.4mm。每个病变均位于与其类型特征性相关的胃特定部位。
结论 在本研究中，未感染幽门螺杆菌的个体在 EGD 检查中发现胃上皮肿瘤的发生率为 0.28%。应对未感染幽门螺杆菌的个体进行内镜检查，以在特征性部位检测到此类肿瘤。
