Autofluorescence imaging for predicting development of metachronous gastric cancer after Helicobacter pylori eradication
Autofluorescence imaging for predicting development of metachronous gastric cancer after Helicobacter pylori eradication
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DOI：
10.1111/j.1440-1746.2010.06442.x
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发表时间：
2010-12-01
影响因子：
4.1
通讯作者：
Tatsuta, Masaharu
中科院分区：
文献类型：
--
作者：
Hanaoka, Noboru;Uedo, Noriya;Tatsuta, Masaharu
背景和目的：虽然根除幽门螺杆菌可降低早期胃癌（EGC）内镜治疗后异时性胃癌的发生率，但在成功根除后仍会发生异时性胃癌，特别是在重度胃体胃炎患者中。我们研究了通过自体荧光成像（AFI）视频内镜诊断的萎缩性胃底胃炎的程度是否可以预测H。患者和方法：共82例患者接受ESD治疗EGC从2003年至2006年，谁接受根除治疗参加了这项研究。用AFI评价慢性萎缩性胃底胃炎的程度，并将其分为封闭型和开放型。主要结果是异时性胃癌的发病率每年监测endoscopy.Results：在中位数为55个月的观察期内，异时性胃癌82例（14.6%）的12。多变量考克斯比例风险分析显示，经年龄、性别、组织学肠上皮化生、血清胃蛋白酶原水平和H.结论：异时性EGC发生于H.幽门螺杆菌根除和AFI诊断的广泛萎缩性胃底胃炎是一个重要的预测因素，因此它可以识别接受ESD治疗的EGC患者，这些患者在根除后仍然需要加强监测。
Background and Aims:Although Helicobacter pylori eradication decreases the incidence of metachronous gastric cancer after endoscopic treatment for early gastric cancer (EGC), metachronous cancer still develops after successful eradication, particularly in patients with severe corpus gastritis. We investigated whether the extent of atrophic fundic gastritis diagnosed by autofluorescence imaging (AFI) videoendoscopy is predictive of development of metachronous gastric cancer after H. pylori eradication in patients treated with endoscopic submucosal dissection (ESD) for EGC.Patients and Methods:A total of 82 patients who underwent ESD for EGC from 2003 to 2006, who received eradication therapy participated in this study. The extent of chronic atrophic fundic gastritis was evaluated by AFI and categorized into closed and open type. The main outcome was the incidence of metachronous gastric cancer detected by annual surveillance endoscopy.Results:During a median observation period of 55 months, metachronous gastric cancer developed in 12 of 82 patients (14.6%). Multivariate Cox's proportional hazard analysis revealed that open-type, atrophic fundic gastritis diagnosed by AFI was significantly associated with development of metachronous gastric cancer (hazard ratio: 4.88, 95% confidence interval [CI]: 1.32-18.2, P = 0.018) after adjustment for age, sex, histological intestinal metaplasia, serum pepsinogen level, and H. pylori status.Conclusions:Metachronous EGC developed after successful H. pylori eradication, and extensive atrophic fundic gastritis diagnosed by AFI was a significant predictor, thus it could identify patients undergoing ESD for EGC who still required intensive surveillance after eradication.