Gastric cancer incidence based on endoscopic Kyoto classification of gastritis  

作　　者：Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Tatsuya Matsuno Gota Fujisawa Akira Toyoshima Hirotoshi Ebinuma Mitsuhiro Fujishiro Yutaka Saito Hidekazu Suzuki 

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 Colorectal Surgery,Japanese Red Cross Medical Center,Tokyo 150-8935,Japan [4]Department of Gastroenterology,Graduate School of Medicine,The University of Tokyo,Tokyo 113-8655,Japan [5]Division of Endoscopy,National Cancer Center Hospital,Tokyo 104-0045,Japan [6]Division of Gastroenterology and Hepatology,Department of Internal Medicine,Tokai University School of Medicine,Isehara 259-1193,Japan

出　　处：《World Journal of Gastroenterology》2023年第31期4763-4773,共11页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Gastric cancer(GC)incidence based on the endoscopic Kyoto classification of gastritis has not been systematically investigated using time-to-event analysis.AIM To examine GC incidence in an endoscopic surveillance cohort.METHODS This study was retrospectively conducted at the Toyoshima Endoscopy Clinic.Patients who underwent two or more esophagogastroduodenoscopies were enrolled.GC incidence was based on Kyoto classification scores,such as atrophy,intestinal metaplasia(IM),enlarged folds(EFs),nodularity,diffuse redness(DR),and total Kyoto scores.Hazard ratios(HRs)adjusted for age and sex were calculated using a Cox hazard model.RESULTS A total of 6718 patients were enrolled(median age 54.0 years;men 44.2%).During the follow-up period(max 5.02 years;median 2.56 years),GC developed in 34 patients.The average frequency of GCs per year was 0.19%.Kyoto atrophy scores 1[HR with score 0 as reference:3.66,95%confidence interval(CI):1.06 to 12.61],2(11.60,3.82-35.27),IM score 2(9.92,4.37-22.54),EF score 1(4.03,1.63-9.96),DR scores 1(6.22,2.65-14.56),and 2(10.01,3.73-26.86)were associated with GC incidence,whereas nodularity scores were not.The total Kyoto scores of 4(HR with total Kyoto scores 0-1 as reference:6.23,95%CI:1.93 to 20.13,P=0.002)and 5-8(16.45,6.29-43.03,P<0.001)were more likely to develop GC,whereas the total Kyoto scores 2-3 were not.The HR of the total Kyoto score for developing GC per 1 rank was 1.75(95%CI:1.46 to 2.09,P<0.001).CONCLUSION A high total Kyoto score(≥4)was associated with GC incidence.The endoscopy-based diagnosis of gastritis can stratify GC risk.

关 键 词：Gastric cancer GASTRITIS ENDOSCOPY ATROPHY Intestinal metaplasia Kyoto classification 

分 类 号：R735.2[医药卫生—肿瘤]