Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Okinaka Memorial Institute for Medical Research, Tokyo, Japan.
J Gastroenterol Hepatol. 2024 Aug;39(8):1580-1585. doi: 10.1111/jgh.16577. Epub 2024 Apr 20.
Since the first report of gastric adenocarcinoma of the fundic-gland type in 2010, the clinicopathological characteristics of gastric neoplasm of the fundic-gland type (GNFG) have become clearer; however, their risk factors remain unclear. This exploratory study aimed to identify the risk factors for GNFG.
We conducted a single-center, retrospective, matched case-control study using medical information recorded at our health management center from January 2014 to July 2023. During this period, 39 240 people underwent upper gastrointestinal endoscopy. GNFG were extracted as cases and matched to controls, according to age and sex, in a 1:8 ratio, excluding those with a history of gastrointestinal surgery and those with a history or comorbidity of cancer. Univariate analysis was used to compare patient background and endoscopic findings. Multivariable analysis was performed, adjusting for factors with P values < 0.1 and antacid use.
A total of 20 GNFG cases and 160 matched healthy controls were included. In the univariate analysis, only reflux esophagitis was significantly more common in GNFG (40.0% vs 18.1%; P = 0.036). Factors antacids and duodenitis had P values < 0.1. Logistic regression analysis was performed, adjusting for antacids, reflux esophagitis, and duodenitis. Antacids and reflux esophagitis were the independent risk factors for GNFG (odds ratio = 3.68 [95% confidence interval: 1.04-11.91] and 3.25 [95% confidence interval: 1.11-9.35]).
Although the sample of patients with GNFG was small, antacids and reflux esophagitis were identified as a risk factor. The pathogenesis of antacids and reflux esophagitis may be involved in the development of GNFG.
自 2010 年首次报道胃底腺型胃腺癌以来，胃底腺型胃肿瘤（GNFG）的临床病理特征变得更加清晰；然而，其危险因素仍不清楚。本探索性研究旨在确定 GNFG 的危险因素。
我们进行了一项单中心、回顾性、病例对照研究，使用了我们健康管理中心 2014 年 1 月至 2023 年 7 月记录的医疗信息。在此期间，有 39240 人接受了上消化道内镜检查。提取 GNFG 作为病例，并根据年龄和性别与对照组按 1:8 的比例进行匹配，排除有胃肠道手术史和有癌症病史或合并症的患者。采用单因素分析比较患者背景和内镜检查结果。进行多变量分析，调整 P 值<0.1 的因素和抗酸剂的使用。
共纳入 20 例 GNFG 病例和 160 例匹配的健康对照者。在单因素分析中，仅反流性食管炎在 GNFG 中更为常见（40.0%比 18.1%；P=0.036）。抗酸剂和十二指肠炎的因素 P 值<0.1。进行了 logistic 回归分析，调整了抗酸剂、反流性食管炎和十二指肠炎。抗酸剂和反流性食管炎是 GNFG 的独立危险因素（比值比=3.68[95%置信区间：1.04-11.91]和 3.25[95%置信区间：1.11-9.35]）。
尽管 GNFG 患者的样本量较小，但抗酸剂和反流性食管炎被确定为危险因素。抗酸剂和反流性食管炎的发病机制可能与 GNFG 的发生有关。
