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上海地区36 857例胃镜胃息肉检出率及临床特征分析

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  • 1.上海交通大学医学院附属瑞金医院北院 a. 消化内科,b. 病理科,上海 202801
    2.上海交通大学医学院附属瑞金医院古北分院消化内科,上海 201103

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

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  • 1a. Department of Gastroenterology, 1b. Department of Pathology, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 201801, China
    2. Department of Gastroenterology, Ruijin Hospital Gubei Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 201103, China

Received date: 2019-07-01

  Online published: 2022-07-15

摘要

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。

本文引用格式

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

Abstract

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.

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