Comparison of endoscopic gastritis based on Kyoto classification between diffuse and intestinal gastric cancer  

作　　者：Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Tomonori Aoki Fumiko Nagura Kosuke Sakitani Yosuke Tsuji Hayato Nakagawa Hidekazu Suzuki Kazuhiko Koike 

机构地区：[1]Department of Gastroenterology,Toyoshima Endoscopy Clinic,Tokyo 157-0066,Japan [2]Department of Gastroenterology and Hepatology,International University of Health and Welfare,Narita Hospital,Narita 286-8520,Japan [3]Department of Gastroenterology,Graduate School of Medicine,The University of Tokyo,Tokyo 113-8655,Japan [4]Internal Medicine,Chitosefunabashi Ekimae Clinic,Tokyo 157-0054,Japan [5]Department of Gastroenterology,Sakiatani Endoscopy Clinic,Narashino 275-0026,Japan [6]Department of Gastroenterology and Hepatology,Tokai University School of Medicine,Isehara 259-1193,Japan

出　　处：《World Journal of Gastrointestinal Endoscopy》2021年第5期125-136,共12页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Gastric cancers can be categorized into diffuse-and intestinal-type cancers based on the Lauren histopathological classification.These two subtypes show distinct differences in metastasis frequency,treatment application,and prognosis.Therefore,accurately assessing the Lauren classification before treatment is crucial.However,studies on the gastritis endoscopy-based Kyoto classification have recently shown that endoscopic diagnosis has improved.AIM To investigate patient characteristics including endoscopic gastritis associated with diffuse-and intestinal-type gastric cancers in Helicobacter pylori(H.pylori)-infected patients.METHODS Patients who underwent esophagogastroduodenoscopy at the Toyoshima Endoscopy Clinic were enrolled.The Kyoto classification included atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.The effects of age,sex,and Kyoto classification score on gastric cancer according to the Lauren classification were analyzed.We developed the Lauren predictive background score based on the coefficients of a logistic regression model using variables independently associated with the Lauren classification.Area under the receiver operative characteristic curve and diagnostic accuracy of this score were examined.RESULTS A total of 499 H.pylori-infected patients(49.6%males;average age:54.9 years)were enrolled;132 patients with gastric cancer(39 diffuse-and 93 intestinal-type cancers)and 367 cancer-free controls were eligible.Gastric cancer was independently associated with age≥65 years,high atrophy score,high intestinal metaplasia score,and low nodularity score when compared to the control.Factors independently associated with intestinal-type cancer were age≥65 years(coefficient:1.98),male sex(coefficient:1.02),high intestinal metaplasia score(coefficient:0.68),and low enlarged folds score(coefficient:-1.31)when compared to diffuse-type cancer.The Lauren predictive background score was defined as the sum of+2(age≥65 years),+1(male sex),+1(endoscopic intestinal metapla

关 键 词：Gastric cancer Lauren classification Endoscopy Pathology GASTRITIS Kyoto classification 

分 类 号：R735.2[医药卫生—肿瘤] R573.3[医药卫生—临床医学]