Oral Glucose Combined with Short-Term Intravenous Nutrition for the Prevention of Hypoglycemia after Painless Endoscopic Gastric Polypectomy

Objective: To explore the application effect of oral glucose combined with short-term intravenous nutrition in preventing postoperative hypoglycemia after painless endoscopic gastric polyp resection, and to provide guidance for better management of patients undergoing such procedures. Methods: A total of 886 patients who underwent painless endoscopic gastric polyp resection in the Department of Gastroenterology, the First Affiliated Hospital of Yangtze University, from January 2020 to December 2021, were selected as the study subjects. According to the random number table method, they were divided into an experimental group and a control group, with 443 cases in each group. Patients in the control group were subjected to routine fasting and water restriction for 8 hours before surgery, and routine fasting for 24 hours after surgery. Short-term intravenous nutrition support was provided through fluid supplementation, and finger blood glucose levels were monitored at 1 hour, 4 hours, and 8 hours after completion of intravenous infusion, or when symptoms such as palpitations and cold sweats occurred. The experimental group received oral administration of 5% glucose solution (500 ml) 2 hours before surgery based on the procedures of the control group. The incidence of preoperative discomfort (hunger, thirst, and fatigue), residual gastric fluid volume, and postoperative hypoglycemia were compared between the two groups. Results: The incidence of postoperative blood glucose Conclusion: Based on the study population, oral glucose combined with short-term intravenous nutrition can effectively prevent the incidence of hypoglycemia in patients undergoing painless endoscopic gastric polyp resection. However, due to the limitations of a single-center study and a small number of cases, its feasibility needs to be further validated with more data from multi-center and large-sample cases.

Multi-slice spiral computed tomography in differential diagnosis of gastric stromal tumors and benign gastric polyps,and gastric stromal tumor risk stratification assessment

BACKGROUND The biological characteristics of gastric stromal tumors are complex,and their incidence has increased in recent years.Gastric stromal tumors(GST)have potential malignant tendencies,and the probability of transformation into malignant tumors is as high as 20%-30%.AIM To investigate the value of multi-slice spiral computed tomography(MSCT)in the differential diagnosis of GST and benign gastric polyps,and GST risk stratification assessment.METHODS We included 64 patients with GST(GST group)and 60 with benign gastric polyps(control group),confirmed by pathological examination after surgery in PLA General Hospital,from January 2016 to June 2021.The differences in the MSCT imaging characteristic parameters and enhanced CT values between the two groups before surgery were compared.According to the National Institutes of Health’s standard,GST is divided into low-and high-risk groups for MSCT imaging characteristic parameters and enhanced CT values.RESULTS The incidences of extraluminal growth,blurred boundaries,and ulceration in the GST group were significantly higher than those in the control group(P<0.05).The CT values and enhanced peak CT values in the arterial phase in the CST group were higher than those in the control group(P<0.05).The MSCT differential diagnosis of GST and gastric polyp sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and areas under the curve(AUCs)were 73.44%,83.33%,26.56%,16.67%,0.784,respectively.The receiver operating characteristic curves were plotted with the arterial CT value and enhanced peak CT value,with a statistical difference.The results showed that the sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of arterial CT in the differential diagnosis of GST and gastric polyps were 80.18%,62.20%,19.82%,37.80%,and 0.710,respectively.The sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of the enhanced peak CT value in the differential diagnosis of GST and gastric polyps were 67.63%,60.40%,32.37%,39.60%,and 0.710,respectively.The incidence of blurred lesion boundaries and ulceration in the high-risk group was significantly higher than that in the low-risk group(P<0.05).The arterial phase and enhanced peak CT values in the high-risk group were significantly higher than those in the low-risk group(P<0.05).CONCLUSION Presurgical MSCT examination has important value in the differential diagnosis of GST and gastric benign polyps and can effectively evaluate the risk grade of GST patients.

Gastric Polyps in a Digestive Endoscopy Center in Dakar

Introduction: The gastric polyp is a tumor protruding into the gastric lumen. It is asymptomatic most often with a risk of malignant degeneration closely related to its histological nature. These data are very rare in Africa. Objectives: Reporting the frequency and endoscopic and histological characteristics of gastric polyps in the digestive endoscopy center of Aristide Le Dantec hospital in Dakar. Patients and methods: This was a retrospective study carried out in the digestive endoscopy center of Aristide Le Dantec Hospital in Dakar from January 2012 to December 2016. We have included all patients with one or more gastric polyps coupled with histological findings available. Results: There were 60 patients with gastric polyps, hence a prevalence of 0.8%. We included 37 patients. Their mean age was 46 years [21 years - 75 years]. The sex-ratio was 0.48. Epigastralgia was the most frequent endoscopic indication (51.3%). The polyp was unique in 26 patients (70.3%) with an average size of 6.87 mm [2 - 15 mm]. Polyps were sessile in 31 cases (83.8%) and pediculate in 6 cases (16.2%). They were most often in the antrum (51.4%). Antral erosions (13.5%) and fundic atrophy (13.5%) were the main associated endoscopic lesions. These were hyperplastic polyps in 27% of cases and adenoma in 16.2% of cases. Chronic atrophic gastritis (10.8%) and intestinal metaplasia (10.8%) were the main histological lesions associated with polyps. Helicobacter pylori (Hp) were present in 17 patients (45.9%). Conclusion: The prevalence of gastric polyps is 0.8% in the endoscopy center of Aristide Le Dantec hospital. They are usually hyperplastic or adenomatous.

Effect of drug treatment on hyperplastic gastric polyps infected with Helicobacter pylorh A randomized, controlled trial

瞄准：为了学习，增生的胃的息肉上的药物疗法的效果与 Helicobacter 感染了 pylori (H pylori ) 。方法：有感染 H pylori 的增生的胃的息肉(在直径的 3-10 公里)的 48 个病人随机被分到一个治疗组( n = 24 )它收到了质子泵禁止者( omeprazole 或 lansoprazole )， clarithromycin ，枸橼酸铋和 tinidazole ，并且控制组织( n = 24 )它收到了胃粘膜( tepretone )的保护的代理人。病人们在注册和 1-12 瞬间术后疗法前定期经历了内视镜检查法和 H pylori 检查。结果：在治疗的 22 个病人组织， 21 在控制组织完成了全部测试协议。在治疗组，息肉消失了 1-12 瞬间(平均， 6.5+/-1.1 瞬间) 在在 22 中的 15 个的治疗以后，病人(68.2%) 和 H pylori 感染在 22 个病人(86.4%) 中的 19 个被根除。然而，在学习，在息肉的没有变化或 H pylori 地位以后的 12 个月在任何控制((b) P【0.01 ) 被看见。结论：最增生的胃的息肉消失在 H pylori 的根除以后。

Changes in the spectrum of gastric polyps in the Chinese population

AIM: To evaluate the change in spectrum of gastric polyps in the Chinese population in the past ten years.METHODS: A total of 157902 consecutive patients undergoing esophagogastroduodenoscopy(EGD) from 2004 to 2013 in a tertiary hospital were retrospectively reviewed using an EGD database.Endoscopic records of 4043 patients diagnosed with gastric polyps were recalled for analysis.Data including demographics,information on polyps such as location,pathological diagnosis,reflux esophagitis and Helicobacter pylori infection were obtained.We focused on epithelial polyps,especially hyperplastic polyps,fundic gland polyps and adenomas,and histological classification of specimens from biopsy and endoscopic polypectomy was performed by professional pathologists,based on the updated guidelines.To explore the age distribution of gastric polyps over time,we divided patients with polyps into four groups: A(aged < 30 years),B(aged 30-44 years),C(aged 45-59 years) and D(aged > 60 years).Differences in localization,age,and sex distribution of gastric polyps were analyzed by statistical software.RESULTS: A total of 157902 EGD procedures were performed in ten years at our digestive endoscopy center,of which 4043 cases were diagnosed with gastric polyps confirmed by pathology.There were 2574(63%) female and 1469(37%) male patients with an average age of 54.7 years.The overall prevalence of gastric polyps was 2.6%(4043/157902).Our database demonstrated a rising prevalence of gastric polyps over the decade,increasing from 1.0%(80/8025) to 4.70%(828/17787) between 2004 and 2013.There has been a change in the spectrum of gastric polyps with the frequencies of FGPs increasing from 19%(15/80) to 77%(638/828) and hyperplastic polyps decreasing from 65%(52/80) to 15%(123/828).Moreover,data on 1921 polyps in 828 patients diagnosed with gastric polyps in 2013 showed that FGP was the most common type in the current polyp spectrum,making up 81.3%(1562/1921).Location and age distribution of gastric polyps have also altered.The prevalence of polyps located in the antrum decreased from 37.5%(30/80) to 9.30%(77/828),with an increasing prevalence of polyps in the corpus,from 45%(36/80) to 64.25%(532/828).The constituent ratio of older patients(aged > 60 years) in the polyp population decreased from 62.5%(50/80) to 32.13%(266/828),while that of patients aged 45-60 years showed an increased trend.CONCLUSION: There was a shift change in the spectrum of gastric polyps in the Chinese population with altered location and age distribution in the past ten years.

Gastric polyps: Association with Helicobacter pylori status and the pathology of the surrounding mucosa, a cross sectional study

aim:To assess the endoscopic characteristics of gastric polyps and their association with Helicobacter pylori(H.pylori)status in a predominantly Hispanic population.m ETHODS:We conducted a retrospective study of all esophagogastroduodenoscopies performed at our institution.Demographic,endoscopic and histopathological data were reviewed.Categorization of patients into Hispanic and Non-Hispanic was based on selfidentification.Patients without resection/biopsy were not included in the analysis.Identification of polyps type was based on histological examination.One way analysis of variance was used to compare continuousvariables among different polyp types and Fisher’s exact test was used compare categorical variables among polyp types.Unadjusted and adjusted comparisons of demographic and clinical characteristics were performed according to the H.pylori status and polyp type using logistic regressions.RESULTS:Of 7090 patients who had upper endoscopy,335 patients had gastric polyps(4.7%).Resection or biopsy of gastric polyps was performed in 296 patients(88.4%)with a total of 442 polyps removed or biopsied.Of 296 patients,87(29%)had hyperplastic polyps,82(28%)had fundic gland polyps and 5(1.7%)had adenomatous polyps.Hyperplastic polyps were significantly associated with positive H.pylori status compared with fundic gland polyps(OR=4.621;95%CI:1.92-11.13,P=0.001).Hyperplastic polyps were also found to be significantly associated with portal hypertensive gastropathy compared with fundic gland polyps(OR=6.903;95%CI:1.41-33.93,P=0.0174).Out of 296 patients,30(10.1%)had a followup endoscopy with a mean duration of 26±16.3 mo.Interval development of cancer was not noted in any of the patients during follow up period.CONCLUSi ON:Gastric hyperplastic polyps were significantly associated with positive H.pylori status and portal hypertensive gastropathy as compared with fundic gland polyps.

Histologic characteristics of gastric polyps in Korea: Emphasis on discrepancy between endoscopic forceps biopsy and endoscopic mucosal resection specimen

瞄准：在朝鲜人口调查胃的息肉的组织学的特征。方法：我们与胃的息肉考察了内视镜的相片和病人的医药记录通过 2003 年 2 月从 1996 年 4 月经历了内视镜的粘膜切除术。结果：从 74 个病人的 85 胃的息肉的一个总数被考察。Male-to-female 比率是 1:1.96。吝啬的年龄是 59.9 +/- 10.8 年。多重息肉在 10.8% 被观察。胃的息肉最经常发生在窦(58.8%) 。resected 标本上的病理学的结果如下：管状腺瘤 45.9% ，增生的息肉 31.8% ，煽动性的息肉 9.4% ，错构瘤 3.5% ，底的腺息肉 2.4% ， tubulovillous 腺瘤 2.4% ，腺癌 2.4% ，发育异常 1.1% ，并且粘膜 pseudolipomatosis 1.1% 。在 resected 标本的内视镜的活体检视和病理之间的差异率是 27.1% 。在息肉和词语索引率的尺寸之间没有关系。结论：在在内视镜的钳活体检视和 resected 标本之间的 histologic 调查结果有可观的差异。全部息肉的组织学的评论的途径应该被执行，特别当一个腺瘤被怀疑时。

Management of hyperplastic gastric polyp following upper gastrointestinal bleeding in infant with Menkes' disease

We report a case of an infant with Menkes' disease(MD) presented at the age of five months,with coffee ground vomiting,melaena with a significant drop of haemoglobin.Urgent endoscopic assessment revealed a friable bleeding trans-pyloric multi-lobulated sessile polyp.Due to further significant upper gastrointestinal bleeding,polypectomy occurred.Endoscopic mucosal resection was performed with a grasp-and-snare technique using a dual channel operating gastroscope.Haemostasis was achieved by application of argon plasma coagulation where required.No perforation occurred.Repeated debridement was required 6 wk after which the growth was excised completely with no further blood transfusion required after that procedure.Histological examination confirmed ulcerated and inflamed hyperplastic polyp.We discuss our endoscopic technique and discuss the reported gastrointestinal manifestation of MD in the literature.

Heterotopic Pancreas Presenting as Gastric Polyp

Heterotopic pancreas is defined as pancreatic tissue found outside the usual anatomical location of the pancreas. It is often an incidental finding and can be found at different sites in the gastrointestinal tract. It may become clinically evident when complicated by pathological changes such as inflammation, bleeding, obstruction, and malignant transformation. We report an unusual case of a 25-year-old male patient with pain epigastrium caused by a polyp at the body of stomach along greater curvature revealed at endoscopy. Endoscopic biopsy was s/o inflammatory pathology. Wide excision of polyp was done and a histological diagnosis of heterotopic pancreas was established. The difficulty of making an accurate preoperative diagnosis is highlighted.

Large pedinculated antral hyperplastic gastric polyp traversed the bulbus causing outlet obstruction and iron deficiency anemia: endoscopic removal

We present here a large (3 cm) hyperplastic gastric polyp prolapsed into duodenum and caused outlet obstruction and iron deficiency anemia in 60 years old male patient.Endoscopic removal was performed successfully.

Large gastric hamartomatous inverted polyp accompanied by advanced gastric cancer:A case report

BACKGROUND Gastric hamartomatous inverted polyps(GHIPs)are benign polyps of the gastric submucosal layer.Currently there are 52 reported cases in the English literature.According to a literature review,approximately 27%of GHIPs show a coexisting carcinoma.CASE SUMMARY A 66-year-old man was referred to our institution with ulcerative lesions detected on esophagogastroduodenoscopy(EGD)during a regular check-up.Other medical findings were nonspecific.The lesions had borderline histologic features that could not exclude malignancy and were followed up with three EGDs and biopsies at intervals of 3 mo.The latest biopsy was revealed as an adenocarcinoma.A total gastrectomy was performed to remove the tumor.The surgical specimen revealed a 6.9 cm×4.5 cm sized GHIP with a coexisting 1.6 cm sized well-differentiated adenocarcinoma which extended to the muscularis propria.The malignancy did not originate from the GHIP but showed an overlap.CONCLUSION A large GHIP,which was unusually presented as an ulcerative lesion,was surgically removed,and was accompanied by advanced gastric cancer.Regular follow-up and thorough examinations of ulcerative lesions with equivocal biopsy have resulted in appropriate diagnosis and treatment.Therefore,aggressive intervention may be beneficial if GHIP is suspected.

Semi/Fully-Automated Segmentation of Gastric-Polyp Using Aquila-Optimization-Algorithm Enhanced Images

The incident rate of the Gastrointestinal-Disease(GD)in humans is gradually rising due to a variety of reasons and the Endoscopic/Colonoscopic-Image(EI/CI)supported evaluation of the GD is an approved practice.Extraction and evaluation of the suspicious section of the EI/CI is essential to diagnose the disease and its severity.The proposed research aims to implement a joint thresholding and segmentation framework to extract the Gastric-Polyp(GP)with better accuracy.The proposed GP detection system consist;(i)Enhancement of GP region using Aquila-Optimization-Algorithm supported tri-level thresholding with entropy(Fuzzy/Shannon/Kapur)and between-class-variance(Otsu)technique,(ii)Automated(Watershed/Markov-Random-Field)and semi-automated(Chan-Vese/Level-Set/Active-Contour)segmentation of GPfragment,and(iii)Performance evaluation and validation of the proposed scheme.The experimental investigation was performed using four benchmark EI dataset(CVC-ClinicDB,ETIS-Larib,EndoCV2020 and Kvasir).The similarity measures,such as Jaccard,Dice,accuracy,precision,sensitivity and specificity are computed to confirm the clinical significance of the proposed work.The outcome of this research confirms that the fuzzyentropy thresholding combined with Chan-Vese helps to achieve a better similarity measures compared to the alternative schemes considered in this research.

Pathophysiological and clinical aspects of gastric hyperplastic polyps

Gastric polyps become a major clinical problem because of high prevalence and tendency to malignant transformation of some of them. The development of gastric hyperplastic polyps results from excessive proliferation of foveolar cells accompanied by their increased exfoliation, and they are macroscopically indistinguishable from other polyps with lower or higher malignant potential. Panendoscopy allows detection and differentiation of gastric polyps, usually after obtaining histopathological biopsy specimens. Unremoved gastric hyperplastic polyps may enlarge and sometimes spontaneously undergo a sequential progression to cancer. For this reason, gastric hyperplastic polyps larger than 5 mm in size should be removed in one piece. After excision of polyps with atypical focal lesion, endoscopic surveillance is suggested depending on histopathological diagnosis and possibility of confirming the completeness of endoscopic resection. Because of the risk of cancer development also in gastric mucosa outside the polyp, neighboring fragments of gastric mucosa should undergo microscopic investigations. This procedure allows for identification of patients who can benefit most from oncological endoscopic surveillance. If Helicobacter pylori(H. pylori) infection of the gastric mucosa is confirmed, treatment strategies should include eradication of bacteria, which may prevent progression of intestinal metaplasia. The efficacy of H. pylori eradication should be checked 3-6 mo later.

Proton pump inhibitors and an emerging epidemic of gastric fundic gland polyposis

Fundic gland polyps are now commonly recognized during endoscopy. These polyps are benign, often multiple and usually detected in the gastric body and fundus. In the past, these polyps were sometimes associated with familial adenomatous polyposis. In recent years, it has become evident that increasing numbers of these polyps are being detected during endoscopic studies, particularly in patients treated with proton pump inhibitors for prolonged periods. In some, dysplastic changes in these polyps have also been reported. Recent studies have suggested that there may be no increase in risk of colon cancer with long-term proton pump inhibitor therapy. While temporarily reassuring, ongoing vigilance, particularly in those genetically predisposed to colon cancer, is still warranted.

Endoscopic excision of a prolapsing malignant polyp which caused intermittent gastric outlet obstruction

A 69-year-old male with chronic lymphocytic leukemia presented with iron deficiency anemia and post-prandial abdominal fullness. Endoscopy showed a large polyp on a stalk, protruding through the pylorus into the duodenum causing intermittent gastric outlet obstruction. While prolapsing gastric antral polyps are usually benign and hyperplastic, inflammatory or regenerative in type, excisional snare polypectomy here led to complete resolution of his symptoms, but showed a malignant polyp.

A white opaque substance-positive gastric hyperplastic polyp with dysplasia

The endoscopic findings of gastric hyperplastic polyps (HPs) with dysplasia have not been well-defined, and the clinical significance of these lesions, including their malignant potential, is unclear. In this report, we describe a case of a white opaque substance (WOS)positive gastric HP with dysplasia. A 76-year-old woman was referred to our hospital for endoscopic resection of a gastric HP. Upper endoscopy revealed a 25-mm whitish and reddish polypoid lesion on the greater curvature in the lower third of the stomach. The whitish part was diagnosed as a WOS using conventional and magnifying endoscopy with narrow band imaging. An examination of the biopsy specimen indicated that the lesion was a typical gastric HP. However, because of its color and the presence of a WOS, we suspected that this lesion was an atypical gastric HP. Therefore, we performed a polypectomy. Histopathologically, diffuse lowto high-grade dysplasia was found on the surface of the polyp. We performed immunohistochemical staining using a monoclonal antibody specific for adipophilin as a marker of lipid droplets (LDs). LDs were detected in approximately all of the neoplastic cells, especially in the surface epithelium of the intervening apical parts and were located in the subnuclear cytoplasm of the neoplastic cells. According to endoscopic and histopathological findings, the WOS-positive epithelium indicated dysplasia of the gastrointestinal phenotype, which could absorb lipids. The presence of a WOS in a gastric HP may be considered an endoscopic finding that is predictive of the neoplastic transformation of a gastric HP. We suggest that a WOS-positive gastric HP should be resected endoscopically to investigate its neoplastic transformation.

胃息肉合并结直肠息肉风险诺谟图预测模型的构建与验证

目的构建胃息肉合并结直肠息肉风险的诺莫图预测模型,并进一步验证模型的预测效能。方法回顾性收集2021年9月至2022年11月新疆维吾尔自治区人民医院消化内科行胃镜检查诊断胃息肉并完善结肠镜检查的患者679例为建模组;依据结肠镜检查结果将其分为有结直肠息肉组与无结直肠息肉组。另收集2022年12月至2023年5月新疆维吾尔自治区人民医院消化内科诊断胃息肉并完善结肠镜检查的患者241例作为验证组。分析胃息肉合并结直肠息肉的影响因素,建立诺谟图预测胃息肉合并结直肠息肉风险的模型;采用受试者操作特征(ROC)曲线评估预测模型的区分度;校准曲线评估数据拟合度;决策曲线分析图评估使用模型的获益情况。结果建模组与验证组一般资料比较,差异无统计学意义(P>0.05)。建模组中有268例发现结直肠息肉。有结直肠息肉组和无结直肠息肉组非酒精性脂肪性肝病、幽门螺杆菌(H.pylori)感染、高同型半胱氨酸血症、2型糖尿病、高血压病、高甘油三酯血症、年龄比较,差异有统计学意义(P<0.05)。非酒精性脂肪性肝病(OR=3.317)、H.pylori感染(OR=3.018)、高同型半胱氨酸血症(OR=3.697)、高甘油三酯血症(OR=4.248)、年龄(OR=1.065)是胃息肉合并结直肠息肉的独立危险因素(P<0.05)。建模组诺谟图预测模型ROC曲线的曲线下面积(AUC)为0.742,验证组AUC为0.737,模型具有较好的区分度。校正曲线提示实际发生率和预测发生率拟合度好。决策曲线图显示模型获益阈值广泛,具有实用价值。结论由非酒精性脂肪性肝病、H.pylori感染、高同型半胱氨酸血症、高甘油三酯血症、年龄建立的预测模型具有较好的预测能力,可为医务人员判断胃息肉合并结直肠息肉的风险提供参考。

圈套器冷切除术在胃小息肉治疗中的应用

目的:探究圈套器冷切除术在胃小息肉治疗中的应用。方法:回顾性分析2021年1月—2022年7月九江市第一人民医院收治的胃小息肉(直径5~9 mm带蒂或亚蒂息肉)患者的临床资料,从接受圈套器冷切除术治疗的患者中随机抽取30例纳入观察组,从接受常规高频电切除术治疗的患者中随机抽取30例纳入对照组。比较两组手术情况、并发症情况、标本回收率、治疗费用和回访术后3个月的复发情况,并比较术前和术后3个月时的胃肠道功能情况[血清胃泌素释放肽前体(ProGRP)、胃蛋白酶原Ⅰ(PGⅠ)]。结果:观察组的手术时长、切除完整率、并发症发生率、治疗费用和复发率均显著优于对照组,差异均有统计学意义(P<0.05);两组术中出血率和标本回收率差异均无统计学意义(P>0.05)。术后3个月时,两组ProGRP和PGⅠ均较术前显著降低,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论:圈套器冷切除术能够明显缩短操作时间,提高胃小息肉切除完整率,降低术后迟发性出血及穿孔等并发症发生率,显著改善胃肠道功能,降低治疗费用,有效避免复发情况。

胃增生性息肉的临床和内镜及病理特征分析

目的分析胃增生性息肉(GHP)的临床、内镜和病理特征。方法回顾性分析北京大学第三医院2005年1月1日至2021年12月31日经胃镜及病理学检查确诊为GHP的4010例患者的临床、内镜及病理资料。结果4010例GHP患者年龄(58±14)岁,其中女性2522例(占62.9%),>50~60岁、>60~70岁为高发年龄段,分别为1106例(27.6%)、1076例(26.8%)。合并幽门螺杆菌感染者795例(19.8%);GHP单发者2811例(70.1%),好发部位为胃体(1456例、36.3%)、贲门(880例、21.9%)及胃窦(697例、17.4%),形态学分型以山田Ⅰ型为主、2401例(59.9%),Ⅱ型也相对较多、931例(23.2%)。2278例(56.8%)患者息肉直径≤0.5 cm;GHP肠化发生率为5.5%(221/4010),异型增生发生率为3.1%(124/4010),癌变发生率为0.3%(12/4010)。GHP背景胃黏膜中,慢性浅表性胃炎占52.0%(2083/4010),慢性萎缩性胃炎占25.9%(1040/4010),其中慢性萎缩性胃炎伴肠化755例、占总体的18.8%,自身免疫性胃炎430例(10.7%),存在异型增生333例(8.4%),合并胃癌共37例(0.9%)。结论GHP多为单发,好发于胃体,息肉存在发生异型增生及癌变的可能性;对于体积较大的息肉,内镜检查时应警惕其恶变可能。

胃息肉合并肠息肉发生相关危险因素及病理特征分析

目的分析胃息肉合并肠息肉发生的相关危险因素及与其病理特征的相关性,以期为高风险人群内镜检查的选择、相关防治措施的制定和医疗资源的节约提供一些依据。方法收集2021年1月至2022年5月消化内科经胃镜和结肠镜检查发现的胃息肉合并肠息肉患者100例作为病例组,结肠镜检查发现的100例单纯肠息肉患者为对照组,收集患者相关资料,比较2组患者间相关资料的差异性,分析胃息肉合并肠息肉发生的高危因素及与其病理特征的相关性。结果2组患者性别、年龄、体重指数(BMI)、生活史、胆系疾病史、脂肪肝、高三酰甘油血症、高胆固醇血症、高尿酸血症、癌胚抗原(CEA)升高、糖类抗原(CA199)升高和CA125升高无统计学意义(P>0.05)。病例组患者幽门螺杆菌(H.Pylori)感染率高于对照组(P<0.05)。2组患者在息肉数目、发生部位、息肉直径和病理类型比较差异无统计学意义(P>0.05)。胃息肉合并肠息肉发生特点与危险因素间的关系分析发现:多发性息肉患者在年龄≥60岁、H.Pylori感染、吸烟史、饮酒史和高CA199较单发性息肉患者比较,差异有统计学意义(P<0.05);息肉直径<10 mm患者在H.Pylori感染情况方面较息肉直径>10 mm患者比较差异有统计学意义(P<0.05);腺瘤性息肉患者在H.Pylori感染情况和CA199升高方面较非腺瘤性息肉差异有统计学意义(P<0.05)。结论胃息肉合并肠息肉发生的主要危险因素为H.Pylori感染,患者息肉病理特征与高龄、H.Pylori感染、吸烟、饮酒和CA199水平间有一定相关性,应注意进行H.Pylori感染根治治疗、改善生活习惯、定期进行肿瘤标志物筛查和内镜检查,以便早期发现病变和进行干预。