上海地区36857例胃镜胃息肉检出率及临床特征分析

Detection rate of gastric polyps and its clinical characteristics in 36857 subjects in Shanghai

目的:分析上海地区胃息肉(gastric polyp,GP)的胃镜检出率及GP的病理特征。方法:收集2012年12月至2019年5月间在上海交通大学医学院附属瑞金医院北院行胃镜检查者36857例,统计胃镜GP检出率及相关病理资料。结果:36857例行胃镜检查者中有3858例检出GP,检出率为10.47%。≥60岁的患者中,检出GP患者3858例,检出率为14.75%。与其他年龄组(<30岁、30~39岁、40~49岁、50~59岁)相比,≥60岁患者中息肉直径≥2 cm的构成比较高,为1.8%(P<0.05),腺瘤性息肉的构成比也较高(1.9%)(P<0.05),合并上皮内瘤变患者45例,占2.9%,构成比明显较高(P<0.05),特别是其中3例高级别上皮内瘤变患者年龄均≥60岁。与<60岁的患者相比,≥60岁的GP患者中合并萎缩性胃炎、肠化生者的构成比明显较高,分别为22.4%、34.0%(P均<0.05);与此相反,存在幽门螺杆菌(Helicobacter pylori,Hp)感染的GP患者中,≥60岁者合并Hp感染的构成比较低(15.1%),差异有统计学意义(P<0.01)。结论:相对60岁以下人群而言,≥60岁人群GP检出率较高,为14.75%;与<60岁的GP患者相比,≥60岁GP患者其息肉直径≥2 cm、腺瘤性息肉构成比较高,其合并上皮内瘤变、萎缩性胃炎、肠化生的构成比也较高,故对于≥60岁的患者需更加重视GP的检出及病理检查。

Objective:To explore the detection rate of gastric polyp(GP)in Shanghai and analyze its clinical characteristics.Methods:A total of 36857 subjects undergone gastroscopy during December 2012 to May 2019 were enrolled,and the detection rate of GP and related pathologic data were analyzed.Results:It revealed that 3858 patients had GP,with a detection rate of 10.47%.In patients over 60 years old,1534 patients were diagnosed as having GP,with a detec-tion rate of 14.75%.Compared with patients in other age groups(<30,30-39,40-49,50-59 years),the constituent ratio of patients with GP diameter≥2.0 was higher(1.8%)(P<0.05),so was with adenomatous polyps(1.9%)and with intraepithelial neoplasia(2.9%)(P<0.05).The only three cases with high-grade intraepithelial neoplasia were all≥60 years old.Besides,the constituent ratio of patients≥60 years old with atrophic gastritis and with intestinal metaplasia were 22.4%and 34.0%,respectively,which were higher than those of patients<60 years old.In contrast,GP patients≥60 years old had a lower constituent ratio of Helicobacter pylori infection(15.1%),lower than that of patients under 60 years old(P<0.01).Conclusions:In comparison with the population<60 years old,population≥60 had a higher detection rate of GP.GP patients of≥60 years old had higher proportion of polyps diameter greater than 2 cm,adenomatous polyps,intraep-ithelial neoplasia,atrophic gastritis,and intestinal metaplasia.Therefore,more attention should be paid to the detection and pathology examination of GP in elderly patients.