Atrophic gastritis and intestinal metaplasia in Japan: Results of a large multicenter study
Atrophic gastritis and intestinal metaplasia in Japan: Results of a large multicenter study
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DOI：
10.1046/j.1523-5378.2001.00042.x
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发表时间：
2001-12-01
期刊：
影响因子：
4.4
通讯作者：
Graham, DY
中科院分区：
文献类型：
--
作者：
Asaka, M;Sugiyama, T;Graham, DY
背景。本研究评价了日本幽门螺杆菌感染与萎缩性胃炎和肠化生的关系。材料与方法。这是一项在日本21个中心进行的多中心研究。共有2455人入选。通过验证的elisa检测幽门螺杆菌状态。萎缩性胃炎的诊断采用组织学检查、刚果红散射内镜或Kimura-Takemoto内镜分型。萎缩性胃炎的发病率从20岁以下的9.4%上升到60岁及以上的70%，并与幽门螺杆菌感染密切相关。幽门螺杆菌感染组萎缩性胃炎总患病率为82.9%(1272/1534)，未感染组为9.8% (90/921)（OR = 44.8; 95% Cl = 34.7 ~ 57.8）。43.1%（542/1258）幽门螺杆菌阳性者出现肠化生，而未感染者为6.2% (51/823)（OR = 11.5; 95% Cl = 8.5-15.5）。幽门螺旋杆菌阳性的日本人萎缩性胃炎在年轻一代中发病率很高（20岁以下38.5%，21-30岁58.5%）。萎缩性胃炎和肠化生与幽门螺杆菌密切相关，而与年龄无关。日本幽门螺杆菌患病率的下降与幽门螺杆菌感染者中萎缩性胃炎患病率的相应下降并不相关。在幽门螺杆菌感染人群中，前体病变萎缩性胃炎伴肠化生的高患病率表明，日本早期胃癌的发展风险将继续保持在较高水平。
Background. This study evaluated the relationship between Helicobacter pylori infection, atrophic gastritis and intestinal metaplasia in Japan.Materials and Methods. This was a multicenter study performed in 21 centers in Japan. A total of 2455 individuals were enrolled. H. pylori status was determined by validated ELISAs. Atrophic gastritis was diagnosed by histology, endoscopy with Congo Red dye scattering or the Kimura-Takemoto endoscopic classification.Results. Atrophic gastritis increased from 9.4% in those less than 20 years of age to > 70% in those aged 60 or older and was strongly associated with H. pylori infection. The overall prevalence of atrophic gastritis in H. pylori infection was 82.9% (1272/1534) compared with 9.8% (90/921) among uninfected (OR = 44.8; 95% Cl = 34.7-57.8). Intestinal metaplasia,was present in 43.1% (542/1258) of H. pylori positive persons compared with 6.2% (51/823) among the uninfected (OR = 11.5; 95% Cl = 8.5-15.5). Atrophic gastritis in H. pylori positive Japanese was very high in the younger generation (38.5% in those aged 20 or less and 58.5% In those 21-30).Conclusions. Atrophic gastritis and intestinal metaplasia were strongly associated with H. pylori and not with aging. The fall in prevalence of H. pylori in Japan has not been associated with a corresponding fall in the prevalence of atrophic gastritis among those with H. pylori infection. The high prevalence of the precursor lesion, atrophic gastritis with intestinal metaplasia, among those with H, pylori infection suggests that the risk of development of early gastric cancer will continue to remain high in Japan.