Laxén F
Scand J Gastroenterol. 1984 Jun;19(4):535-40.
The starting material consisted of 357 subjects with gastric polyps found at endoscopy. Histologically, these cases were divided in four groups: adenoma, 8%; hyperplastic polyp, 34%; foveolar hyperplasia, 21%; and inflammatory polyp, 36%. Of these 210 patients were for various reasons no longer available for follow-up study. Endoscopic follow-up study for about 8 years (range, 5-15.5 years) was performed in 147 patients. At the follow-up examination, in 103 patients morphologic signs and in 92 of these immunological and functional signs of pernicious anaemia were examined. The prevalences of severe atrophic gastritis affecting mainly the body mucosa (26%), parietal cell and/or intrinsic factor blocking antibodies (25%), low serum vitamin B12 levels (8%), and overt pernicious anaemia (treated and new cases, 11%) were significantly higher than in equal numbers of age- and sex-matched controls examined in a similar manner. Gastric cancer was found in 3 (2%) cases followed up for more than 5 years. This is seven times the expected incidence, with a 95% confidence interval of the risk ratio (1.5-20.9). The high frequency of gastric cancer and pernicious anemia emphasizes the importance of long-term endoscopic follow-up study of patients with gastric polyps.
研究起始对象为357例在内镜检查中发现胃息肉的患者。组织学上，这些病例分为四组：腺瘤，8%；增生性息肉，34%；小凹增生，21%；炎性息肉，36%。其中210例患者因各种原因无法继续进行随访研究。对147例患者进行了约8年（范围5 - 15.5年）的内镜随访研究。在随访检查中，对103例患者检查了形态学体征，对其中92例检查了恶性贫血的免疫学和功能学体征。主要累及胃体黏膜的重度萎缩性胃炎（26%）、壁细胞和/或内因子阻断抗体（25%）、血清维生素B12水平降低（8%）以及显性恶性贫血（经治疗病例和新发病例，11%）的患病率显著高于以类似方式检查的年龄和性别匹配的对照组。在随访5年以上的病例中发现3例（2%）胃癌。这是预期发病率的7倍，风险比的95%置信区间为（1.5 - 20.9）。胃癌和恶性贫血的高发病率强调了对胃息肉患者进行长期内镜随访研究的重要性。
