Helicobacter-negative gastritis: a distinct entity unrelated to Helicobacter pylori infection
Helicobacter-negative gastritis: a distinct entity unrelated to Helicobacter pylori infection
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DOI：
10.1111/apt.13007
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发表时间：
2015-01-01
影响因子：
7.6
通讯作者：
Sonnenberg, A.
中科院分区：
文献类型：
--
作者：
Genta, R. M.;Sonnenberg, A.
背景当胃粘膜中没有检测到具有螺杆菌性胃炎（Hp-胃炎）典型特征的有机体时，诊断为螺杆菌阴性胃炎。如果幽门螺杆菌阴性胃炎主要包括漏诊的幽门螺杆菌感染，其患病率应该代表这些感染在人群中的恒定百分比，并且它们的临床流行病学特征将重叠。胃活检患者的临床和组织病理学数据（2008年1月至2013年12月）。我们将患者分配到高（12%）和低（6%）幽门螺杆菌患病率地区定义的邮政编码为基础的数据。幽门螺杆菌阳性和阴性胃炎的患病率的性别，年龄和状态表示为百分比的总研究人群分层sought.ResultsOf 895323例，10.6%的幽门螺杆菌胃炎和1.5%的幽门螺杆菌阴性胃炎。男性比女性更常见的是HP胃炎，而不是螺旋杆菌阴性胃炎（OR 1.17，95%CI：1.16-1.19）。虽然幽门螺杆菌-胃炎在高患病率地区比低患病率地区更普遍（OR 3.65，95%CI：3.57-3.74），但幽门螺杆菌阴性胃炎仅受基础幽门螺杆菌患病率的影响最小（1.7% vs. 1.5%）。年龄特异性Hp-胃炎患病率在第4 ~ 5个十年达到高峰;幽门螺杆菌阴性胃炎表现出较低且相对平坦的模式。幽门螺杆菌阳性和阴性胃炎的地理分布无显著相关性。肠上皮化生被发现在13.0%的Hp胃炎患者和6.1%的幽门螺杆菌阴性胃炎（OR 0.43，95%CI：0.40-0.47）。结论这些数据表明，在绝大多数情况下，幽门螺杆菌阴性胃炎是一个疾病学和流行病学不同的实体，值得进一步调查。
BackgroundHelicobacter-negative gastritis is diagnosed when no organisms are detected in a gastric mucosa with typical features of Helicobacter gastritis (Hp-gastritis). If Helicobacter-negative gastritis consisted mostly of missed' Helicobacter infections, its prevalence should represent a constant percentage of these infections in a population, and their clinico-epidemiological features would overlap.AimTo compare the epidemiologic patterns of Hp-positive and Hp-negative gastritis.MethodsFrom a pathology database, we extracted demographic, clinical and histopathological data from patients with gastric biopsies (1.2008-12.2013). We allocated patients to high (12%) and low (6%) H.pylori prevalence regions defined by ZIP code-based data. The prevalence of H.pylori-positive and -negative gastritis by sex, age and state were expressed as a per cent of the total study population stratified accordingly.ResultsOf 895323 patients, 10.6% had Hp-gastritis and 1.5% Helicobacter-negative gastritis. Hp-gastritis, but not Helicobacter-negative gastritis, was more common in males than females (OR 1.17, 95% CI: 1.16-1.19). While Hp-gastritis was more prevalent in high than in low-prevalence areas (OR 3.65, 95% CI: 3.57-3.74), Helicobacter-negative gastritis was only minimally affected by the underlying H.pylori prevalence (1.7% vs. 1.5%). The age-specific prevalence of Hp-gastritis peaked in the 4th to 5th decades; Helicobacter-negative gastritis exhibited a low and relatively flat pattern. The geographic distribution of H.pylori-positive and -negative gastritis showed no significant correlation. Intestinal metaplasia was found in 13.0% of patients with Hp-gastritis and in 6.1% of those with Helicobacter-negative gastritis (OR 0.43, 95% CI: 0.40-0.47).ConclusionThese data suggest that Helicobacter-negative gastritis is, in the vast majority of cases, a nosologically and epidemiologically distinct entity that deserves further investigation.