Topographic patterns of intestinal metaplasia and gastric cancer
Topographic patterns of intestinal metaplasia and gastric cancer
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DOI：
10.1111/j.1572-0241.2000.02074.x
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发表时间：
2000-06-01
影响因子：
9.8
通讯作者：
Genta, RM
中科院分区：
文献类型：
--
作者：
Cassaro, M;Rugge, M;Genta, RM
目的：肠上皮化生在胃癌发生中的作用已被横断面和纵向研究所证实。本研究的目的是确定是否，在胃癌的高风险人群中，不同的地形模式和肠上皮化生的表型与不同程度的癌症risk.METHODS：共68例哥伦比亚胃癌患者和67例对照非溃疡性消化不良进行了广泛的活检协议进行了研究。肠上皮化生进行了半定量评估组织学和组织化学的特点。在患者和对照组中，应用斯皮尔曼相关性检验来检验化生病变的胃分布是否导致与不同癌症风险相关的特定地形图模式。3）25例癌症患者和4例对照者的“Magenstra beta e”（涉及贲门到幽门的小弯）。与两种不太广泛的模式相比，这种模式与更高的癌症风险相关（OR = 5.7; 95%CI：1.3-26）;和4）“弥漫性”，基本上涉及除胃底外的整个胃粘膜，是13名癌症患者所独有的。癌症的OR为12.2; 95% CI：2.0-72.9。不完全型化生显着相关的总化生的程度，也与更大的癌症risk.CONCLUSIONS：在人群中胃癌的高风险，肠化生的扩展与其“不完全”表型的程度，并显着相关的癌症风险增加。肠上皮化生沿着胃小弯（从贲门到幽门前区）的范围和位置都是癌症风险最高的患者。(Am胃肠病学杂志2000;95：1431-1438. (C)2000年，我胃肠病学）。
OBJECTIVE: The role of intestinal metaplasia in gastric oncogenesis has been demonstrated by both cross-sectional and longitudinal studies. This study was designed to determine whether, in a population at high risk for gastric cancer, different topographical patterns and phenotypes of intestinal metaplasia were associated with different degrees of cancer risk.METHODS: A total of 68 Colombian patients with gastric cancer and 67 controls with nonulcer dyspepsia were studied by an extensive biopsy protocol. Intestinal metaplasia was assessed semiquantitatively by histology and was characterized histochemically. In both patients and controls, the Spearman's correlation test was applied to the test if the gastric distribution of metaplastic lesions resulted in specific topographical patterns associated with different risks for cancer.RESULTS: Four topographical patterns of intestinalization emerged: 1) "Focal," in 14 cancer patients and 16 controls; 2) "Antrum-predominant," in seven cancer patients and six controls; 3) "Magenstra beta e" (involving the lesser curvature from cardia to pylorus) in 25 cancer patients and four controls. This pattern was associated with higher cancer risk (OR = 5.7; 95% CI: 1.3-26) than were the two less extensive patterns; and 4) "Diffuse," involving essentially the entire gastric mucosa with the exception of the fundus, was unique to 13 cancer patients. The OR for cancer was 12.2; 95% CI: 2.0-72.9. Incomplete-type metaplasia significantly correlated with the extent of total metaplasia and was also associated with greater cancer risk.CONCLUSIONS: In a population with high risk for gastric cancer, the extension of intestinal metaplasia correlates with the extent of its "incomplete" phenotype and is significantly associated with increased cancer risk. Both the extent and location of intestinal metaplasia along the lesser curvature (from the cardia to the prepyloric zones) identify patients with the highest cancer risk. (Am J Gastroenterol 2000;95:1431-1438. (C) 2000 by Am. Coll. of Gastroenterology).