近15年1566例胃息肉临床流行病学分析

Clinical and Epidemiological Analysis of 1 566 Cases of Gastric Polyps in Recent 15 Years

目的:探讨胃息肉的临床、内镜及病理学特点和近15年间的变化趋势。方法:回顾性收集攀枝花市第二人民医院2003年1月至2017年12月期间经电子胃镜及病理学诊断的胃息肉病例,回顾性分析其性别、年龄,内镜下息肉部位、息肉数目、息肉大小、山田分型,息肉组织病理学分型,以及幽门螺杆菌(Helicobacter pylori,Hp)感染情况等。结果:34 828例行胃镜检查,共检出胃息肉患者1 566例,检出率为4.50%;女性胃息肉的检出率明显高于男性(5.93%vs 3.15%;χ2=156.554,P<0.001);<40岁、40~49岁、50~59岁、≥60岁4个年龄组胃息肉的检出率分别为1.73%、3.52%、3.95%、6.68%,胃息肉检出率随着年龄的增长呈明显上升趋势(χ2趋势=242.175,P<0.001)。胃息肉的好发部位主要在胃体(42.02%),73.56%胃息肉患者为单发,72.54%患者息肉最大直径<0.5cm,形态学分型以山田Ⅱ型(56.07%)和Ⅰ型(28.93%)为主;胃息肉患者Hp感染率21.78%,病理学常见类型为增生性息肉(43.10%)、炎性息肉(34.80%)和胃底腺息肉(20.05),息肉组织癌变率为1.02%。近15年来胃镜下胃息肉的检出率呈逐年上升趋势,自2003年的1.95%上升至2017年的6.98%。结论:女性、老年人群是主要高发人群,增生性和炎性息肉仍然是最主要病理类型,胃息肉的检出率逐年增加。

Objective: To explore the clinical, endoscopic and pathological characteristics of gastric polyps and the trend in recent 15 years. Methods: A total of 1 566 gastric polyps patients diagnosed by gastroscopy and pathology in our hospital from January 2003 to December 2017 were retrospectively collected. Sex, age, location, number, size, type of polyps, histopathological type of polyps, and helicobacter pylori infection were analyzed retrospectively. Results: In total, 34 828 cases of gastric polyps were examined by gastroscopy, and the detection rate was 4. 50%. The detection rate of gastric polyps in women was significantly higher than that in men ( 5. 93% vs 3. 15%;χ^2 = 56. 554, P < 0. 001). The detection rate of gastric polyps in four age groups was 1. 73%(< 40), 3. 52%( 40 - 49), 3. 95%( 50 - 59) and 6. 68%(≥60), respectively. The detection rate of gastric polyps increased significantly with the increase of age (χ^2trend = 242. 175, P < 0. 001). The most common site of gastric polyps was the gastric body ( 42. 02%). 73. 56% of gastric polyps were solitary. 72. 54% of patients were with polyp maximum diameter < 0. 5 cm. The main morphological types were Yamada type II ( 56. 07%) and type I ( 28. 93%). The infection rate of helicobacter pylori in patients with gastric polyps was 21. 78%. Common pathological types include hyperplastic polyps ( 43. 10%), inflammatory polyps ( 34. 80%) and gastric fundic gland polyps ( 20. 05). The cancer incidence rate of polyps was 1. 02%. In the past 15 years, the detection rate ( gastroscopy) of gastric polyps increased year by year, from 1. 95% in 2003 to 6. 98% in 2017. Conclusion: Females and the elderly are the main high-risk groups. Hyperplastic and inflammatory polyps are still the main pathological types. The detection rate of gastric polyps is increasing year by year.