Clinical features of cardiac nodularity-like appearance induced by Helicobacter pylori infection.
Clinical features of cardiac nodularity-like appearance induced by Helicobacter pylori infection.
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DOI：
10.3748/wjg.v26.i35.5354
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发表时间：
2020-09-21
影响因子：
4.3
通讯作者：
Koike K
中科院分区：
文献类型：
--
作者：
Nishizawa T;Sakitani K;Suzuki H;Yoshida S;Kataoka Y;Nakai Y;Ebinuma H;Kanai T;Toyoshima O;Koike K
我们以前曾报道过幽门螺杆菌(H.Pylori)相关性结节性胃炎可同时发生在胃窦部和贲门部。心脏结节样表现(以下称为心脏结节)对幽门螺杆菌感染的诊断有很高的预测准确性。在之前的研究中，我们只包括首次接受fi幽门螺杆菌感染评估的患者，并排除了有根除病史的患者。因此，心脏结节的患病率和临床特征仍不清楚。对心脏结节进行横断面研究，探讨心脏结节的特点。2017年5月至2019年8月在丰岛内窥镜诊所连续接受食道胃十二指肠镜检查的患者纳入本研究。我们纳入了幽门螺杆菌阴性、幽门螺杆菌阳性和根除幽门螺杆菌的患者，排除了幽门螺杆菌状态不明和根除失败的患者。幽门螺杆菌感染以血清抗H。幽门螺杆菌抗体和尿素呼气试验或组织学检查。心脏结节的定义为在食管胃交界处2厘米内出现散在的白色圆形小着色的粟粒状结节。在窄带成像模式下，结节显示为白色。我们收集了有关患者基线特征的数据。最终共纳入1078名患者。在幽门螺杆菌阴性患者中，心脏结节和胃窦结节各占0.14%。在Hp阳性患者中，心脏结节和胃窦结节的检出率分别为54.5%和29.5%。在Hp根除的患者中，心脏结节和胃窦结节的确诊率分别为4.5%和0.6%。在Hp阳性和根除患者中，心脏结节的发生率明显高于胃窦结节。幽门螺杆菌根除患者的心脏结节和胃窦结节发生率显著低于幽门螺杆菌阳性患者(P<；0.001)。有心脏结节的患者明显比无心脏结节的患者年轻(P=0.0013)。有心脏结节的肠化生积分显著低于无心脏结节的肠化积分(P=0.0216)。在幽门螺杆菌根除的患者中，有心脏结节的患者与无心脏结节的患者相比，最近接受根除的时间明显更晚(P<；0.0001)。本报告概述了心脏结节的发病率和临床特征，并证实其与幽门螺杆菌感染密切相关。
We have previously reported that Helicobacter pylori (H. pylori)-associated nodular gastritis could occur in both the antrum and the cardia. Cardiac nodularity-like appearance (hereafter, called as cardiac nodularity) had a high predictive accuracy for the diagnosis of H. pylori infection. In the previous study, we included only the patients who were evaluated for H. pylori infection for the first time, and excluded patients with a history of eradication. Therefore, the prevalence and clinical features of cardiac nodularity remains unknown. To perform this cross-sectional study to explore the characteristics of cardiac nodularity. Consecutive patients who underwent esophagogastroduodenoscopy between May, 2017 and August, 2019 in the Toyoshima Endoscopy Clinic were enrolled in this study. We included H. pylori-negative, H. pylori-positive, and H. pylori-eradicated patients, and excluded patients with unclear H. pylori status and eradication failure. H. pylori infection was diagnosed according to serum anti-H. pylori antibody and the urea breath test or histology. Cardiac nodularity was defined as a miliary nodular appearance or the presence of scattered whitish circular small colorations within 2 cm of the esophagogastric junction. Nodularity was visualized as whitish in the narrow-band imaging mode. We collected data on the patients’ baseline characteristics. A total of 1078 patients were finally included. Among H. pylori-negative patients, cardiac nodularity and antral nodularity were recognized in 0.14% each. Among H. pylori-positive patients, cardiac nodularity and antral nodularity were recognized in 54.5% and 29.5%, respectively. Among H. pylori-eradicated patients, cardiac nodularity and antral nodularity were recognized in 4.5% and 0.6%, respectively. The frequency of cardiac nodularity was significantly higher than that of antral nodularity in H. pylori-positive and -eradicated patients. The frequencies of cardiac nodularity and antral nodularity in H. pylori-eradicated patients were significantly lower than those in H. pylori-positive patients (P < 0.001). The patients with cardiac nodularity were significantly younger than those without cardiac nodularity (P = 0.0013). Intestinal metaplasia score of the patients with cardiac nodularity were significantly lower than those without cardiac nodularity (P = 0.0216). Among H. pylori-eradicated patients, the patients with cardiac nodularity underwent eradication significantly more recently compared with those without cardiac nodularity (P < 0.0001). This report outlines the prevalence and clinical features of cardiac nodularity, and confirm its close association with active H. pylori infection.
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影响因子：
3.2
作者：
Al-Enezi, Saleh A.;Alsurayei, Saqer A.;El-Dousari, Ahmad
通讯作者：
El-Dousari, Ahmad
影响因子：
4.4
作者：
Luzza, F;Pensabene, L;Pallone, F
通讯作者：
Pallone, F
成功根除幽门螺杆菌后的1年内检测到胃癌的特征。
影响因子：
2.4
作者：
Nishizawa T;Suzuki H;Arano T;Yoshida S;Yamashita H;Hata K;Kanai T;Yahagi N;Toyoshima O
通讯作者：
Toyoshima O
影响因子：
6.3
作者：
Shiotani, Akiko;Kamada, Tomoari;Haruma, Ken
通讯作者：
Haruma, Ken
影响因子：
4.3
作者：
Kubosawa, Yoko;Mori, Hideki;Suzuki, Hidekazu
通讯作者：
Suzuki, Hidekazu