胃多发白色扁平隆起病变:一种新型胃增生性息肉  

Multiple white and flat elevated lesions observed in the stomach:a new subtype of hyperplastic polyps

作　　者：周胜云[1] 段志辉 ZHOU Sheng-yun;DUAN Zhi-hui(Department of Endoscopy, Xingtai People′s Hospital, Hebei Province, Xingtai 054000, China)

机构地区：[1]河北省邢台市人民医院内镜中心,河北邢台054000

出　　处：《河北医科大学学报》2020年第8期896-898,904,共4页Journal of Hebei Medical University

摘　　要：目的探讨胃多发白色扁平隆起病变(multiple white and flat elevated lesions,MWFLs)的临床、病理特征及其相关危险因素。方法选取行胃镜检查的患者926例。采用传统白光和窄带成像(Narrow-band imaging,NBI)技术观察胃黏膜,分析MWFLs的临床病理和内镜特征。结果926例受试者中诊断MWFLs 75例,检出率为8.1%(75/926)。MWFLs阳性组女性占比和服用质子泵抑制剂(proton pump inhibitors,PPIs)占比高于MWFLs阴性组,年龄大于MWFLs阴性组(P<0.05);2组幽门螺杆菌阳性、胃黏膜萎缩、PPIs使用时间差异无统计学意义(P>0.05)。MWFLs病理结果为黏膜慢性炎及胃底腺小凹上皮增生性变化,未见肠上皮化生及萎缩改变。Logisitic回归分析结果显示,女性(OR=2.112,95%CI:1.180~3.762),年龄(>55岁)(OR=2.541,95%CI:1.400~4.611)、服用PPIs(OR=1.951,95%CI:1.052~3.613)是MWFLs的危险因素。结论老年、女性、长期口服PPIs是MWFLs的危险因素,病理学表现为胃底腺小凹上皮增生。内镜医师应该注意避免与肠上皮化生混淆。Objective To clarify the clinicopathological features of multiple white and flat elevated lesions(MWFLs)in the stomach and to explore the risk factors in affected individuals.Methods The subjects were 926 consecutive individuals undergoing endoscopy.The white light and narrow-band images of gastric mucosa were reviewed.The clinicopathological and endoscopic characteristics of multiple white and flat elevated lesions observed in the stomach were analyzed.Results The prevalence rate of MWFLs was 8.1%(75/926).The proportion of female and PPI use in the MWFLs positive group was higher than that in the MWFLs negative group(P<0.05).The age in the MWFLs positive group was significantly higher than that in the MWFLs negative group(P<0.05).There was no significant difference between two groups regarding H.P.status,atrophy,and the duration of PPI use(P>0.05).The pathological results of MWFLs were chronic mucosa inflammation and gastric fundus epithelium hyperplasia,but no intestinal metaplasia and atrophy were observed.With the following risk factors identified on a logistic regression analysis:use of proton pump inhibitors,odds ratio(OR=1.951,95%CI:1.052-3.613),female sex(OR=2.112,95%CI:1.180-3.762),and older age(>55 years)(OR=2.541,95%CI:1.400-4.611)were risk factors for MWFLs.Conclusion Long-term use of PPIs,female sex and age are risk factrors for MWFLs,and hyperplastic changes of the foveolar epithelium in the fundic glands is observed.We believe that endoscopists should recongize these lesions,and these lesions are not intestinal metaplasia.

关 键 词：白色扁平隆起病变 胃 质子泵抑制剂 幽门螺杆菌 

分 类 号：R573.9[医药卫生—消化系统]