胃黄色瘤与萎缩性胃炎相关性的单中心回顾性研究

Relationship Between Gastric Xanthelasma and Atrophic Gastritis: A Single Center Retrospective Study

背景:胃黄色瘤是一种少见的胃部良性病变,确切病因不明。研究发现胃黄色瘤患者多合并萎缩性胃炎。目的:探讨胃黄色瘤与萎缩性胃炎的相关性及其临床意义。方法:连续纳入2015年4月—2016年3月在山西省人民医院行胃镜检查的10 645例患者,采集人口统计学、临床、内镜、组织学相关信息进行回顾性分析。结果:入组患者胃黄色瘤检出率为2.9%。胃黄色瘤患者的平均年龄和萎缩性胃炎检出率(47.9%对16.6%)显著高于非胃黄色瘤患者,且胃黄色瘤患者胃黏膜萎缩程度更为严重(P均<0.001);多因素Logistic回归分析显示年龄≥50岁(校正OR=1.349,95%CI:1.042~1.747,P=0.023)和萎缩性胃炎(校正OR=3.892,95%CI:3.076~4.924,P<0.001)是胃黄色瘤的独立危险因素。萎缩性胃炎患者的胃黄色瘤检出率亦显著高于非萎缩性胃炎患者(7.9%对1.8%,P<0.001)。对性别、年龄匹配的胃黄色瘤与非胃黄色瘤患者的分析表明胃黄色瘤独立于性别、年龄而与萎缩性胃炎相关(P<0.001)。此外,胃黄色瘤患者中,合并萎缩性胃炎者的多发性胃黄色瘤检出率显著高于未合并萎缩性胃炎者(32.0%对13.8%,P<0.001)。结论:胃黄色瘤的发生与患者年龄以及萎缩性胃炎及其严重程度有关。萎缩性胃炎可能是胃黄色瘤的病因之一,而胃黄色瘤可能是萎缩性胃炎胃黏膜病变的另一种表现形式。

Background： Gastric xanthelasma is a benign and uncommon lesion with unknown etiology. It has been noted that atrophic gastritis is frequently seen in patients with gastric xanthelasma. Aims： To investigate the relationship between gastric xanthelasma and atrophic gastritis and its clinical significance. Methods： A total of 10 645 consecutive patients who had undergone gastroscopy from Apr. 2015 to Mar. 2016 at the Shanxi Provincial People＇s Hospital were enrolled and analyzed retrospectively with respect to their demographic,clinical,endoscopic and histological features. Results： The prevalence of gastric xanthelasma in patients recruited in this study was 2. 9%. The mean age and prevalence of atrophic gastritis（ 47. 9% vs. 16. 6%） were significantly higher and the gastric atrophy was more severe in patients with gastric xanthelasma than those without（ P all 0. 001）. Multivariate Logistic regression analysis revealed that age ≥50 years（ adjusted OR = 1. 349,95% CI： 1. 042 ~ 1. 747,P = 0. 023） and atrophic gastritis（ adjusted OR = 3. 892,95% CI：3. 076 ~ 4. 924,P〈 0. 001） were independently related to the presence of gastric xanthelasma. Likewise,the prevalence of gastric xanthelasma in patients with atrophic gastritis was significantly higher than those without（ 7. 9% vs. 1. 8%,P〈 0. 001）. Age-and sex-matched control analysis proved the correlation between gastric xanthelasma and atrophic gastritis（ P〈0. 001）. In addition,multiple xanthelasma was more prevalent in gastric xanthelasma patients with atrophic gastritis than those without（ 32. 0% vs. 13. 8%,P〈0. 001）. Conclusions： Gastric xanthelasma is correlated with age and presence and severity of atrophic gastritis. Atrophic gastritis might be one of the etiological factors of gastric xanthelasma,and gastric xanthelasma might be an atypical mucosal lesion caused by gastric atrophy.