胃底腺息肉的分类用于预测幽门螺杆菌阴性的家族性腺瘤性息肉病患者的胃肿瘤。
Classification of fundic gland polyps for predicting gastric neoplasms in Helicobacter pylori-negative patients with familial adenomatous polyposis.
发表日期：2024 Aug 22
作者：
Yusaku Shimamoto, Yoji Takeuchi, Shingo Ishiguro, Shin-Ichi Nakatsuka, Hiroshi Yunokizaki, Yasumasa Ezoe, Satoki Shichijo, Akira Maekawa, Takashi Kanesaka, Sachiko Yamamoto, Koji Higashino, Noriya Uedo, Ryu Ishihara, Michihiro Mutoh, Hideki Ishikawa
来源：
Gastric Cancer
摘要：
在家族性腺瘤性息肉病（FAP）患者中，胃底腺息肉（FGP）被认为是胃肿瘤的危险因素。我们推测FAP患者中的FGP从胃体大弯向小弯定向扩散，并研究FGP的分布与胃肿瘤发展之间的关系。我们从两个机构中提取了195名FAP患者并回顾了他们的病历。根据FGP分布对胃息肉病进行分类（P0，无FGP；P1，局限于胃底或胃体大弯；P2，扩散至前壁或后壁；P3，累及小弯的近半部；P3，累及胃小弯的近半部；P3，累及胃小弯的近半部。 195例符合条件的患者分为肿瘤组（n = 54例，28%）和非肿瘤组（n = 141例，72%）。总体而言，24% 的患者幽门螺杆菌 (H. pylori) 呈阳性。在FGP分布中，幽门螺杆菌阴性患者的胃肿瘤患者发生率趋于从P0到P4逐渐扩大，但幽门螺杆菌阳性患者的胃肿瘤患者发生率却没有显着增加。此外，在幽门螺杆菌阴性患者中，肿瘤的可能性从 P0 到 P4 持续增加，P4 时的比值比最高（95% 置信区间）为 14.1 (2.5-154.4)。此外，多变量分析显示 P4 和 Spigelman 分期 ≥ III 期与胃肿瘤的发生显着相关。FGP 分布与 FAP 患者胃肿瘤的发生相关。© 2024。作者获得国际胃癌协会和 The International Gastric Cancer Association 的独家许可。日本胃癌协会。
In familial adenomatous polyposis (FAP) patients, fundic gland polyps (FGPs) have been considered a risk factor for gastric neoplasms. We speculated that FGPs in FAP patients spread directionally from the greater to the lesser curvature of the gastric body and investigated the relationship between the distribution of FGPs and gastric neoplasm development.We extracted 195 FAP patients from two institutions and reviewed their medical records. Gastric polyposis was classified based on the FGP distribution (P0, no FGPs; P1, localized in the fundus or greater curvature of the gastric body; P2, spreading to the anterior or posterior wall; P3, involving the proximal half of the lesser curvature; and P4, spreading from P3 to the anal side of the lesser curvature).The 195 eligible patients were divided into the neoplasm group (n = 54, 28%) and the non-neoplasm group (n = 141, 72%). Overall, 24% of the patients were Helicobacter pylori (H. pylori)-positive. In the FGP distribution, the rate of patients with gastric neoplasm tended to increase significantly with each step towards an increasingly wide distribution from P0 to P4 in H. pylori-negative patients, but not in H. pylori-positive ones. In addition, in H. pylori-negative patients, the likelihood of neoplasm increased consistently from P0 to P4, with the highest odds ratio (95% confidence interval) at P4 of 14.1 (2.5-154.4). Furthermore, multivariate analysis showed P4 and Spigelman stage ≥III were significantly associated with gastric neoplasm development.FGP distribution was correlated with gastric neoplasm development in FAP patients.© 2024. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.