京都胃炎分类评分系统识别我国胃癌高风险人群的应用价值

Efficacy of Kyoto classification of gastritis and scoring system in identifying Chinese patients at high risk for gastric cancer

目的探讨京都胃炎分类评分系统对我国胃癌高风险人群提示的有效性,为我国胃癌筛查提供借鉴。方法回顾性分析中国人民解放军总医院第六医学中心行胃镜检查的1250例患者,其中胃癌患者145例(观察组),非胃癌患者1105例(对照组)。根据京都胃炎分类评分标准,白光胃镜下对患者背景胃黏膜进行评分比较。结果观察组京都胃炎分类评分总分显著高于对照组[(3.29±2.20)分vs(1.06±1.46)分,P<0.01],且观察组在萎缩、肠上皮化生、弥漫性发红评分均高于对照组(P<0.01)。Logistic回归分析显示,萎缩评分高(OR=5.944)和黏膜弥漫性发红评分高(OR=3.105)是胃癌患病的危险因素。此外,早期胃癌患者在萎缩、肠上皮化生、弥漫性发红、鸡皮样改变评分及总分上也高于对照组(P<0.01)。结论京都胃炎分类评分系统有助于在白光胃镜下识别胃癌及早期胃癌高风险人群。

Objective To investigate the efficacy of Kyoto classification of gastritis and scoring system in the identifi-cation of Chinese patient at high risk for gastric cancer,and to provide reference for the screening of gastric cancer in China.Methods A total of 1250 patients who underwent gastroscopy in the Sixth Medical Center of chinese PLA Gen-eral Hospital were retrospectively analyzed,145 gastric cancer patients were included in the observation group and 1105 patients without gastric cancer were included in the control group.The background gastric mucosa under white light gas-troscope of these patients were compared according to Kyoto classification of gastritis and scoring system.Results The Kyoto score in the observation group was significantly higher than that in the control group[(3.29±2.20)scores vs(1.06±1.46)scores,P<0.01].Besides,the scores of atrophy,intestinal metaplasia and diffuse redness in the obser-vation group were also higher than those in the control group(P<0.01).Logistic regression analysis showed that atro-phy(OR=5.944)and diffuse redness(OR=3.105)were risk factors for gastric cancer.In addition,the scores of atrophy,intestinal metaplasia,diffuse redness,nodularity and Kyoto score in early gastric cancer patients were higher than those in the control group(P<0.01).Conclusion Kyoto classification of gastritis and scoring system is helpful for the identification of patients at high risk for gastric cancer and early gastric cancer under white light endoscopy.