10 137例胃息肉的临床及病理特征分析

何金龙; 陈磊; 代剑华; 张昊翔; 冯吉; 魏周玲; 房殿春

doi:10.16016/j.1000-5404.201709178

您当前的位置：

首页 >

文章列表页 >

10 137例胃息肉的临床及病理特征分析

临床医学 | 更新时间：2026-01-09

- 10 137例胃息肉的临床及病理特征分析
- Clinical and pathological characteristics of gastric polyps: a report of 10 137 patients
- 第三军医大学学报 2018年40卷第3期页码：248-254
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院全军消化病研究所
- 作者简介：
  
  [ 房殿春，E-mail:fangdianchun@hotmail.comFANG Dianchun, E-mail:fangdianchun@hotmail.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201709178
  中图分类号： R446.8;R573;R735.2
- 收稿：2017-09-24，
  
  修回：2017-11-16，
  
  纸质出版：2018-02-15
- 稿件说明：
移动端阅览
何金龙, 陈磊, 代剑华, 等. 10 137例胃息肉的临床及病理特征分析[J]. 第三军医大学学报, 2018,40(3):248-254.

Jinlong HE, Lei CHEN, Jianhua DAI, et al. Clinical and pathological characteristics of gastric polyps: a report of 10 137 patients[J]. Journal of Third Military Medical University, 2018, 40(3): 248-254.
何金龙, 陈磊, 代剑华, 等. 10 137例胃息肉的临床及病理特征分析[J]. 第三军医大学学报, 2018,40(3):248-254. DOI： 10.16016/j.1000-5404.201709178.

Jinlong HE, Lei CHEN, Jianhua DAI, et al. Clinical and pathological characteristics of gastric polyps: a report of 10 137 patients[J]. Journal of Third Military Medical University, 2018, 40(3): 248-254. DOI： 10.16016/j.1000-5404.201709178.

摘要

目的

分析重庆地区胃息肉的临床及病理特征。

方法

回顾性分析西南医院消化内镜中心数据库2007年1月至2016年12月检出的10 137例胃息肉患者的内镜报告及临床资料。

结果

10年间胃息肉的病理谱发生了显著的变化，增生性息肉所占比例由66.39%下降到43.05%(

0.001)，而胃底腺息肉由25.04%上升到48.47%(

0.001)；

H.pylori

感染率由57.78%下降到37.42%(

0.05)；异型增生发生率由3.79%下降到0.90%(

0.001)；高级别上皮内瘤变(high-grade intraepithelial neoplasia，HIN)发生率由1.81%下降到0.56%(

0.01)。增生性胃息肉所占比例随着年龄增加而呈下降的趋势，由≤30岁组的73.62%下降到＞70岁组的48.69%(

0.001)；腺瘤性息肉检出率随着年龄的增加而上升，由31~40岁组的0.34%上升到＞70岁组的6.28%(

0.001)；异型增生和HIN在60岁以上人群中发生率分别是不超过60岁人群的3.89倍和4.75倍(

0.001)。反流性食管炎发生率在胃底腺组(6.86%)明显高于非胃底腺组(3.54%)(

0.001)；胃底腺息肉组中

H.pylori

感染率(28.48%)明显低于非胃底腺息肉组(45.30%)(

0.001)；异型增生发生率在腺瘤性、增生性和胃底腺息肉中分别为60.47%、0.53%和0.20%；HIN发生率在腺瘤性、增生性和胃底腺息肉中分别为47.67%、0.07%和0.03%。胃息肉的数量及位置分布在不同时间段、不同年龄组、不同病理类型间均存在差异。

结论

重庆地区10年间增生性胃息肉明显下降，几乎无恶变风险的胃底腺息肉已成为主要的病理类型；临床中是否有必要对所有胃息肉进行切除治疗，应结合息肉病理类型、临床特征及患者意愿后做出差异性的管理策略。

Abstract

Objective

To investigate the clinical and pathological characteristics of gastric polyps in Chongqing region.

Methods

Endoscopic reports and clinical data of 10 137 consecutive patients with gastric polyps diagnosed in our center from January 2007 to December 2016 were collected and retrospectively analyzed.

Results

During the period of 10 years

the spectrum of gastric polyps was altered with the frequency of hyperplastic polyp (HPP) decreasing from 66.39% to 43.05%(

0.001)

while that of fundic gland polyp (FGP) increasing from 25.04% to 48.47%(

0.001). The prevalence of

H. Pylori

infection

dysplasia and high-grade intraepithelial neoplasia (HIN) was declined from 57.78% to 37.42%(

0.05)

3.79% to 0.90%(

0.001)

and 1.81% to 0.56%(

0.01)

respectively. The ratio of the HPPs patients was reduced with the age increasing

and the ratio was decreased from 73.62% in the ≤30 years old group to 48.69% i

70 years old group(

0.001). However

the ratio of adenomatous polyp was increased from 0.34% in the group aged 31 to 40 years old to 6.28% in those

70 years old(

0.001). The prevalence of dysplasia and HIN was increased by 3.89 and 4.75 times

respectively(

0.001)

in the group aged

60 years than those ≤60 years old. The incidence of reflux esophagitis in the FGPs patients was higher than those without (6.86%

3.54%)(

0.001)

whereas

it showed inversely about the infection rate of

H. pylori

(28.48%

45.30%)(

0.001). The incidence of dysplasia were 60.47%

0.53% and 0.20% respectively in adenomatous polyp

HPP and FGP

as well as 47.67%

0.07% and 0.03% for HIN in adenomatous polyp

HPP and FGP. There were significant difference in the number and location of gastric polyps in different time periods

age groups and pathological types.

Conclusion

The prevalence of gastric hyperplastic polyps is obviously decreased in the past 10 years

and FGPs with hardly malignant potential are the most common type. Therefore

whether it is necessary to resect all polyps when encountered under endoscope

physicians should take into consideration pathological patterns

clinical characteristics and decision of patients and make the different management strategies finally.

关键词

Keywords

references

GODDARD A F, BADRELDIN R, PRITCHARD D M, et al . The management of gastric polyps[J ] . Gut, 2010, 59(9): 1270-1276. DOI:10.1136/gut.2009.182089.

NAYUDU S K, NIAZI M, BALAR B, et al . A rare complication of hyperplastic gastric polyp[J ] . Case Rep Gastrointest Med, 2013, 2013: 631975. DOI:10.1155/2013/631975.

HE H Y, SHEN Z B, FANG Y, et al . Bleeding and hyperpyrexia in an adult with gastric inflammatory fibroid polyp[J ] . Chin Med J, 2013, 126(13): 2594.

VLACANCICH R, SULTAN M, AL-KAWAS F. Gastric outlet obstruction caused by prolapsed gastric polyp into the pyloric channel[J]. Clin Gastroenterol Hepatol, 2014, 12(5): A27-A28. DOI:10.1016/j.cgh.2013.12.015.

ISLAM R S, PATEL N C, LAM-HIMLIN D, et al . Gastric polyps: a review of clinical, endoscopic, and histopathologic features and management decisions[J ] . Gastroenterol Hepatol (N Y), 2013, 9(10): 640-651.

PARK D Y, LAUWERS G Y. Gastric polyps: classification and management[J]. Arch Pathol Lab Med, 2008, 132(4):633-640.DOI:10.1043/1543-2165(2008)132 2.0.CO; 2.

CARMACK S W, GENTA R M, GRAHAM D Y, et al . Management of gastric polyps: a pathology-based guide for gastroenterologists[J ] . Nat Rev Gastroenterol Hepatol, 2009, 6(6):331-341.DOI:10.1038/nrgastro.2009.70.

SHAIB Y H, RUGGE M, GRAHAM D Y, et al . Management of gastric polyps: an endoscopy-based approach[J ] . Clin Gastroenterol Hepatol, 2013, 11(11): 1374-1384. DOI:10.1016/j.cgh.2013.03.019.

FAN N N, 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. DOI:10.3748/wjg.v21.i33.9758.

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. DOI:10.1111/j.1440-1746.2012.07116.x.

ZHENG E, NI S, YU Y, et al . Impact of gender and age on the occurrence of gastric polyps: data analysis of 69575 southeastern Chinese patients[J ] . Turk J Gastroenterol, 2015, 26(6): 474-479. DOI:10.5152/tjg.201 5.0099.

CARMACK S W, GENTA R M, SCHULER C M, 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.DOI:10.1038/ajg.2009.139.

NAM S Y, PARK B J, RYU K H, et al . Effect of Helicobacter pylori infection and its eradication on the fate of gastric polyps[J ] . Eur J Gastroenterol Hepatol, 2016, 28(4): 449-454. DOI:10.1097/MEG.0000000000000553.

LJUBICIĆ N, BANIĆ M, KUJUNDZIĆ M, et al . The effect of eradicating helicobacter pylori infection on the course of adenomatous and hyperplastic gastric polyps[J ] . Eur J Gastroenterol Hepatol, 1999, 11(7): 727-730. DOI:10.1097/00042737-199907000-00008.

TOKUNAGA K, TANAKA A, TAKAHASHI S. Gastric hyperplastic polyps and H. pylori infection, their relationship and effects of eradication therapy[J]. Nippon Rinsho, 2013, 71(8): 1449-1452.

OHKUSA T, TAKASHIMIZU I, FUJIKI K, et al . Disappearance of hyperplastic polyps in the stomach after eradication of Helicobacter pylori. A randomized, clinical trial[J ] . Ann Intern Med, 1998, 129(9): 712-715. DOI:10. 7326/0003-4819-129-9-199811010-00006.

ZHANG D H, ZHOU L Y, LIN S R, et al . Recent changes in the prevalence of helicobacter pylori infection among children and adults in highor low-incidence regions of gastric cancer in China[J ] . Chin Med J, 2009, 122(15): 1759-1763.

HUNT R H, XIAO S D, MEGRAUD F, et al . Helicobacter pylori in developing countries. World gastroenterology organisation global guideline[J ] . J Gastrointestin Liver Dis, 2011, 20(3): 299-304.

MARTIN F C, CHENEVIX-TRENCH G, YEOMANS N D. Systematic review with meta-analysis: fundic gland polyps and proton pump inhibitors[J]. Aliment Pharmacol Ther, 2016, 44(9): 915-925. DOI:10.1111/apt.13800.

TRAN-DUY A, SPAETGENS B, HOES A W, et al . Use of proton pump inhibitors and risks of fundic fland polyps and gastric cancer: systematic review and meta-analysis[J ] . Clin Gastroenterol Hepatol, 2016, 14(12): 1706-1719. DOI:10. 1016/j.cgh.2016.05.018.

JALVING M, KOORNSTRA J J, WESSELING J, et al . Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy[J ] . A liment Pharmacol Ther, 2006, 24(9): 1341-1348. DOI:10.1111/j.1365-2036.2006. 03127.x.

RICHTER J E, RUBENSTEIN J H. Presentation and epidemiology of gastroesophageal reflux disease[J]. Gastroenterology, 2017.. DOI: 10.1053/j.gastro.2017.07.045.

ELHANAFI S, SAADI M, LOU W, et al . Gastric polyps: association with helicobacter pylori status and the pathology of the surrounding mucosa, a cross sectional study[J ] . World J Gastrointest Endosc, 2015, 7(10): 995-1002. DOI:10.4253/wjge.v7.i10.995.

HUANG C Z, LAI R X, MAI L, et al . Relative risk factors associated with the development of fundic gland polyps[J ] . Eur J Gastroenterol Hepatol, 2014, 26(11): 1217-1221. DOI:10.1097/MEG.0000000000000199.

ASGE Standards of Practice Committee, EVANS J A, CHANDRASEKHARA V, et al . The role of endoscopy in the management of premalignant and malignant conditions of the stomach[J ] . Gastrointest Endosc, 2015, 82(1): 1-8. DOI:10. 1016/j.gie.2015.03.1967.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

川藏线官兵幽门螺杆菌感染的相关因素分析

幽门螺杆菌感染对胃黏膜上皮细胞REDD1表达的影响及调控机制

联动成像内镜辅助诊断幽门螺杆菌感染的临床价值

肾上腺髓质素在幽门螺杆菌感染中的表达调控及其功能的初步研究

504例胃息肉发生相关因素的调查研究