目的:比较不同可操作的与胃癌风险联系的肠上皮化生评价(operative link for gastric intestinal metaplasia assessment,OLGIM)分期的慢性萎缩性胃炎(chronic atrophic gastritis,CAG)患者中医证素分布特征,探索影响CAG患者病情进展的...目的:比较不同可操作的与胃癌风险联系的肠上皮化生评价(operative link for gastric intestinal metaplasia assessment,OLGIM)分期的慢性萎缩性胃炎(chronic atrophic gastritis,CAG)患者中医证素分布特征,探索影响CAG患者病情进展的中医证素。方法:对CAG患者进行问卷调查,采用证素辨证方法,分析其证素分布特征,探讨不同OLGIM证素分布特征与差异。结果:共纳入640例CAG患者,其中OLGIM低危组367例,OLGIM高危组273例。获得中医病位证素5个:胃、脾、肝、心(神)、肾;病性证素8个:气滞、湿阻、气虚、血瘀、热郁、阳虚、食积、阴虚。OLGIM低危组与高危组之间中医病位证素分布差异无统计学意义(P>0.05);OLGIM高危组气虚、血瘀、阳虚证素占比较高,与低危组比较差异有统计学意义(P<0.05)。OLGIM高危组患者复合证素比例显著高于OLGIM低危组(P<0.05)。结论:CAG的病位主要在胃,与脾、肝、心(神)、肾密切相关;病性上总体呈现“虚实夹杂”的复合证候特点;随着CAG病情加重,虚、瘀的证素占比增加,可能在CAG患者胃癌风险增高中起了推动作用。展开更多
Chronic gastritis is a persistent inflammation of the gastric mucosa. The Sydney System is the most widely used classification of this disease but it does not allow a ranking of patients according to the evolutionary ...Chronic gastritis is a persistent inflammation of the gastric mucosa. The Sydney System is the most widely used classification of this disease but it does not allow a ranking of patients according to the evolutionary potential of the disease, unlike the classifications: “Operative Link On Gastritis Assessment” (OLGA) and “Operative Link on Gastritis Intestinal Metaplasia Assessment” (OLGIM). Our goals are to apply and evaluate the three classifications: the Sydney System, OLGA and OLGIM and to draw possible correlations. This is a retrospective, descriptive, single-center study performed on all cases of chronic gastritis, diagnosed at the laboratory of Pathological Anatomy Unit of Joseph Ravoahangy Andrianavalona University Hospital from January 1, 2013 to December 31, 2017. A review and application of the three main classification systems was performed on each case. We included 298 cases. The mean age was 50.85 years. The sex ratio was 1.48. The high-risk stages according to the “Operative Link On Gastritis Assessment” (OLGA) system and the “Operative Link on Gastritis Intestinal Metaplasia Assessment” (OLGIM) system were 0.67% and 2.68%, respectively. We observed a correlation between the two systems with discordance of 5%. The use of the two new systems allows the assessment of the progressive potential of gastritis in patients at risk of developing gastric cancer. For optimal effectiveness of both classifications, biopsies should be performed according to the Sydney System recommendations.展开更多
BACKGROUND Risk stratification for patients with gastric precancerous lesions for endoscopic surveillance remains controversial.AIM To analysis of patients having developed gastric adenocarcinoma during the period of ...BACKGROUND Risk stratification for patients with gastric precancerous lesions for endoscopic surveillance remains controversial.AIM To analysis of patients having developed gastric adenocarcinoma during the period of follow-up.METHODS We conducted a retrospective study on patients having undergone upper endoscopy prior to the development of gastric adenocarcinoma. The presence and stage of precancerous lesions as well as subtype of intestinal metaplasia at the baseline endoscopy got evaluated. Literature mini-review was performed.RESULTS Out of 1681 subjects in the Biobank, gastric adenocarcinoma was detected in five cases in whom previous endoscopy data with biopsies either from the corpus or antral part were available. All of the patients had incomplete intestinal metaplasia during the baseline endoscopy;all three subjects in whom intestinal metaplasia subtyping was performed according to Filipe et al, had Type Ⅲ intestinal metaplasia. Two of the five cases had low Operative Link on Gastritis Assessment(OLGA) and Operative Link on Gastritis Intestinal Metaplasia Assessment(OLGIM) stages(Ⅰ-Ⅱ) at the baseline.CONCLUSION The presence of incomplete intestinal metaplasia, in particular, that of Type Ⅲ is a better predictor for gastric adenocarcinoma development than OLGA/OLGIM staging system. Subtyping of intestinal metaplasia have an important role in the risk stratification for surveillance decisions.展开更多
文摘目的:比较不同可操作的与胃癌风险联系的肠上皮化生评价(operative link for gastric intestinal metaplasia assessment,OLGIM)分期的慢性萎缩性胃炎(chronic atrophic gastritis,CAG)患者中医证素分布特征,探索影响CAG患者病情进展的中医证素。方法:对CAG患者进行问卷调查,采用证素辨证方法,分析其证素分布特征,探讨不同OLGIM证素分布特征与差异。结果:共纳入640例CAG患者,其中OLGIM低危组367例,OLGIM高危组273例。获得中医病位证素5个:胃、脾、肝、心(神)、肾;病性证素8个:气滞、湿阻、气虚、血瘀、热郁、阳虚、食积、阴虚。OLGIM低危组与高危组之间中医病位证素分布差异无统计学意义(P>0.05);OLGIM高危组气虚、血瘀、阳虚证素占比较高,与低危组比较差异有统计学意义(P<0.05)。OLGIM高危组患者复合证素比例显著高于OLGIM低危组(P<0.05)。结论:CAG的病位主要在胃,与脾、肝、心(神)、肾密切相关;病性上总体呈现“虚实夹杂”的复合证候特点;随着CAG病情加重,虚、瘀的证素占比增加,可能在CAG患者胃癌风险增高中起了推动作用。
文摘Chronic gastritis is a persistent inflammation of the gastric mucosa. The Sydney System is the most widely used classification of this disease but it does not allow a ranking of patients according to the evolutionary potential of the disease, unlike the classifications: “Operative Link On Gastritis Assessment” (OLGA) and “Operative Link on Gastritis Intestinal Metaplasia Assessment” (OLGIM). Our goals are to apply and evaluate the three classifications: the Sydney System, OLGA and OLGIM and to draw possible correlations. This is a retrospective, descriptive, single-center study performed on all cases of chronic gastritis, diagnosed at the laboratory of Pathological Anatomy Unit of Joseph Ravoahangy Andrianavalona University Hospital from January 1, 2013 to December 31, 2017. A review and application of the three main classification systems was performed on each case. We included 298 cases. The mean age was 50.85 years. The sex ratio was 1.48. The high-risk stages according to the “Operative Link On Gastritis Assessment” (OLGA) system and the “Operative Link on Gastritis Intestinal Metaplasia Assessment” (OLGIM) system were 0.67% and 2.68%, respectively. We observed a correlation between the two systems with discordance of 5%. The use of the two new systems allows the assessment of the progressive potential of gastritis in patients at risk of developing gastric cancer. For optimal effectiveness of both classifications, biopsies should be performed according to the Sydney System recommendations.
文摘BACKGROUND Risk stratification for patients with gastric precancerous lesions for endoscopic surveillance remains controversial.AIM To analysis of patients having developed gastric adenocarcinoma during the period of follow-up.METHODS We conducted a retrospective study on patients having undergone upper endoscopy prior to the development of gastric adenocarcinoma. The presence and stage of precancerous lesions as well as subtype of intestinal metaplasia at the baseline endoscopy got evaluated. Literature mini-review was performed.RESULTS Out of 1681 subjects in the Biobank, gastric adenocarcinoma was detected in five cases in whom previous endoscopy data with biopsies either from the corpus or antral part were available. All of the patients had incomplete intestinal metaplasia during the baseline endoscopy;all three subjects in whom intestinal metaplasia subtyping was performed according to Filipe et al, had Type Ⅲ intestinal metaplasia. Two of the five cases had low Operative Link on Gastritis Assessment(OLGA) and Operative Link on Gastritis Intestinal Metaplasia Assessment(OLGIM) stages(Ⅰ-Ⅱ) at the baseline.CONCLUSION The presence of incomplete intestinal metaplasia, in particular, that of Type Ⅲ is a better predictor for gastric adenocarcinoma development than OLGA/OLGIM staging system. Subtyping of intestinal metaplasia have an important role in the risk stratification for surveillance decisions.
