收稿日期: 2019-07-01
网络出版日期: 2022-07-15
Detection rate of gastric polyps and its clinical characteristics in 36 857 subjects in Shanghai
Received date: 2019-07-01
Online published: 2022-07-15
目的: 分析上海地区胃息肉(gastric polyp, GP)的胃镜检出率及GP的病理特征。方法: 收集2012年12月至2019年5月间在上海交通大学医学院附属瑞金医院北院行胃镜检查者36 857例,统计胃镜GP检出率及相关病理资料。结果: 36 857例行胃镜检查者中有3858例检出GP,检出率为10.47%。≥60岁的患者中,检出GP患者3 858例,检出率为14.75%。与其他年龄组(<30岁、30~39岁、40~49岁、50~59岁)相比,≥60岁患者中息肉直径≥2 cm的构成比较高,为1.8%(P<0.05),腺瘤性息肉的构成比也较高(1.9%)(P<0.05),合并上皮内瘤变患者45例,占2.9%,构成比明显较高(P<0.05),特别是其中3例高级别上皮内瘤变患者年龄均≥60岁。与<60岁的患者相比,≥60岁的GP患者中合并萎缩性胃炎、肠化生者的构成比明显较高,分别为22.4%、34.0%(P均<0.05);与此相反,存在幽门螺杆菌(Helicobacter pylori,Hp)感染的GP患者中,≥60岁者合并Hp感染的构成比较低(15.1%),差异有统计学意义(P<0.01)。结论: 相对60岁以下人群而言,≥60岁人群GP检出率较高,为14.75%;与<60岁的GP患者相比,≥60岁GP患者其息肉直径≥2 cm、腺瘤性息肉构成比较高,其合并上皮内瘤变、萎缩性胃炎、肠化生的构成比也较高,故对于≥60岁的患者需更加重视GP的检出及病理检查。
周郁芬, 王柏凯, 罗芳秀, 徐莹, 丁燕飞, 袁晓琴, 陈平, 吴云林 . 上海地区36 857例胃镜胃息肉检出率及临床特征分析[J]. 诊断学理论与实践, 2020 , 19(04) : 420 -425 . DOI: 10.16150/j.1671-2870.2020.04.018
Objective: To explore the detection rate of gastric polyp (GP) in Shanghai and analyze its clinical characteristics. Methods: A total of 36 857 subjects undergone gastroscopy during December 2012 to May 2019 were enrolled, and the detection rate of GP and related pathologic data were analyzed. Results: It revealed that 3 858 patients had GP, with a detection rate of 10.47%. In patients over 60 years old, 1 534 patients were diagnosed as having GP, with a detection rate of 14.75%. Compared with patients in other age groups (<30, 30-39, 40-49, 50-59 years), the constituent ratio of patients with GP diameter ≥2.0 was higher(1.8%)(P<0.05), so was with adenomatous polyps (1.9%) and with intraepithelial neoplasia (2.9%)(P<0.05). The only three cases with high-grade intraepithelial neoplasia were all ≥60 years old. Besides, the constituent ratio of patients ≥60 years old with atrophic gastritis and with intestinal metaplasia were 22.4% and 34.0%, respectively,which were higher than those of patients <60 years old. In contrast, GP patients ≥60 years old had a lower constituent ratio of Helicobacter pylori infection (15.1%), lower than that of patients under 60 years old (P<0.01). Conclusions: In comparison with the population <60 years old, population ≥60 had a higher detection rate of GP. GP patients of ≥60 years old had higher proportion of polyps diameter greater than 2 cm, adenomatous polyps, intraepithelial neoplasia, atrophic gastritis, and intestinal metaplasia. Therefore, more attention should be paid to the detection and pathology examination of GP in elderly patients.
[1] | 陈灏珠, 林果为. 实用内科学[M]. 北京: 人民卫生出版社, 2013. |
[2] | Sonnenberg A, Genta RM. Prevalence of benign gastric polyps in a large pathology database[J]. Dig Liver Dis, 2015, 47(2):164-169. |
[3] | Fan NN, Yang J, Sun G, et al. Changes in the spectrum of gastric polyps in the Chinese population[J]. World J Gastroenterol, 2015, 21(33):9758-9764. |
[4] | Kelly PJ, Lauwers GY. Clinical guidelines: consensus for the management of patients with gastric polyps[J]. Nat Rev Gastroenterol Hepatol, 2011, 8(1):7-8. |
[5] | Cao H, Wang B, Zhang Z, et al. Distribution trends of gastric polyps: an endoscopy database analysis of 24 121 northern Chinese patients[J]. J Gastroenterol Hepatol, 2012, 27(7):1175-1180. |
[6] | Wang HB, Xu L. Clinical features analysis in 365 cases of gastric polyps[J]. Clinical Medicine of China, 2010, 26:581-584. |
[7] | Wei X. Clinical and pathological analysis in 579 cases of gastric polyps[J]. Chinese Journal of Laboratory Diagnosis. 2009, 13:951-952. |
[8] | Argüello Viúdez L, Córdova H, Uchima H, et al. Gastric polyps: retrospective analysis of 41,253 upper endoscopies[J]. Gastroenterol Hepatol[J]. Gastroenterol Hepatol, 2017, 40(8):507-514. |
[9] | Martin FC, Chenevix-Trench G, Yeomans ND. Systematic review with meta-analysis: fundic gland polyps and proton pump inhibitors[J]. Aliment Pharmacol Ther, 2016, 44(9):915-925. |
[10] | Fukuda M, Ishigaki H, Sugimoto M, et al. Histological analysis of fundic gland polyps secondary to PPI therapy[J]. Histopathology, 2019, 75(4):537-545. |
[11] | Jain R, Chetty R. Gastric hyperplastic polyps: a review[J]. Dig Dis Sci, 2009, 54(9):1839-1846. |
[12] | Shi J, Qu YP, Hou P. Pathogenetic mechanisms in gastric cancer[J]. World J Gastroenterol, 2014, 20(38):13804-13819. |
[13] | Fan NN, Yang J, Sun G, et al. Changes in the spectrum of gastric polyps in the Chinese population[J]. World J Gastroenterol, 2015, 21(33):9758-9764. |
[14] | Yoon SB, Park JM, Lim CH, et al. Incidence of gastric cancer after endoscopic resection of gastric adenoma[J]. Gastrointest Endosc, 2016, 83(6):1176-1183. |
[15] | Goddard AF, Badreldin R, Pritchard DM, et al. The management of gastric polyps[J]. Gut, 2010, 59(9):1270-1276. |
[16] | Markowski AR, Markowska A, Guzinska-Ustymowicz K. Pathophysiological and clinical aspects of gastric hyperplastic polyps[J]. World J Gastroenterol, 2016, 22(40):8883-8891. |
[17] | Carmack SW, Genta RM, Schuler CM, et al. The current spectrum of gastric polyps: a 1-year national study of over 120,000 patients[J]. Am J Gastroenterol, 2009, 104(6):1524-1532. |
[18] | Na HK, Cho CJ, Bae SE, et al. Atrophic and metaplastic progression in the background mucosa of patients with gastric adenoma[J]. PLoS One, 2017, 12(1):e0169456. |
[19] | Fukuda M, Ishigaki H, Ban H, et al. No transformation of a fundic gland polyp with dysplasia into invasive carcinoma after 14 years of follow-up in a proton pump inhibitor-treated patient: A case report[J]. Pathol Int, 2018, 68(12):706-711. |
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