Clinicopathological features and prognosis of developed gastric cancer based on the diagnosis of mucosal atrophy and enlarged folds of stomach by double-contrast upper gastrointestinal barium X-ray radiography
Clinicopathological features and prognosis of developed gastric cancer based on the diagnosis of mucosal atrophy and enlarged folds of stomach by double-contrast upper gastrointestinal barium X-ray radiography
复制标题
DOI：
10.1007/s12328-021-01445-z
复制
发表时间：
2021-05-20
影响因子：
1
通讯作者：
Koike, Kazuhiko
中科院分区：
文献类型：
--
作者：
Yamamichi, Nobutake;Shimamoto, Takeshi;Koike, Kazuhiko
背景幽门螺杆菌引起的慢性胃炎的两个主要特征是胃黏膜萎缩和胃褶皱增大。这些先前被证明是胃癌的危险指标，但它们对发展为胃癌的临床病理特征的可预测性尚不清楚。此外，还需要通过适当的UGI筛查随访来降低胃癌死亡率的证据。方法对5134例一般健康的UGI-XR体检者进行10年的前瞻性观察，随访UGI-XR或上消化道内镜检查（UGI-ES）一次以上。结果随访开始时，1515例（29.5%）出现粘膜萎缩，990例（19.5%）出现皱襞增大。用于血清抗h。幽门螺杆菌IgG阳性1301例（25.3%），可能阳性177例（3.4%），阴性3656例（71.2%）。在10年的观察期间，15例受试者发生胃癌，其中13例发生粘膜萎缩，10例发生皱襞扩大。这两个特征被认为是胃癌发病率的有用指标，但它们与肿瘤分期或肿瘤发展的组织学类型没有显著相关性。5134名受试者中，10年间只有1人死于胃癌，明显低于日本死亡率预测的胃癌死亡人数（6.78人/ 10年）。结论胃粘膜萎缩和胃皱襞扩大与发生性胃肿瘤的临床病理特征均无显著相关性。适当随访UGI-XR或UGI-ES筛查可降低胃癌相关死亡风险。
Background Mucosal atrophy and enlarged folds of stomach by double-contrast upper gastrointestinal barium X-ray radiography (UGI-XR) are two major features of Helicobacter pylori-induced chronic gastritis. These were previously shown to be risk indicators of gastric cancer, but their predictability for clinicopathological characters of developed gastric cancer is unelucidated. In addition, evidence for decreasing the mortality of gastric cancer by appropriate follow-up of UGI screening is needed. Methods The 5134 generally healthy UGI-XR examinees, who underwent follow-up UGI-XR or upper gastrointestinal endoscopy (UGI-ES) more than once, were prospectively observed for 10 years. Results At the beginning of follow-up, 1515 (29.5%) had mucosal atrophy and 990 (19.5%) had enlarged folds. For the serum anti-H. pylori IgG, 1301 (25.3%) were positive, 177 (3.4%) were possibly positive, and 3656 (71.2%) were negative. During the 10-year observation period, gastric cancer developed in 15 subjects, among which 13 had mucosal atrophy and 10 had enlarged folds. These two features were expectedly useful indicators for gastric cancer incidence, but they showed no significant association with tumor stage or histological type of developed cancer. Only one of the 5134 subjects died of gastric cancer during 10 years, which was significantly lower than the predicted number of gastric cancer death (6.78 for 10 years) according to the mortality rate in Japan. Conclusions Neither mucosal atrophy nor enlarged folds of stomach showed a significant association with clinicopathological features of developed gastric tumors. Appropriate follow-up of cancer screening by UGI-XR or UGI-ES can reduce the risk of gastric cancer-related death.