BACKGROUND The pathogenesis of non-ampullary duodenal epithelial tumors(NADETs)is not fully understood.NADETs that express gastric-type mucin phenotypes(GNADETs)are noteworthy because of their high malignancy.Gastric ...BACKGROUND The pathogenesis of non-ampullary duodenal epithelial tumors(NADETs)is not fully understood.NADETs that express gastric-type mucin phenotypes(GNADETs)are noteworthy because of their high malignancy.Gastric foveolar metaplasia,from which G-NADETs originate,protects the duodenal mucosa from gastric acidity.As gastric acid secretion is affected by endoscopic gastric mucosal atrophy(EGMA),we hypothesized that EGMA would be associated with GNADETs.AIM To evaluate the association between EGMA and the occurrence of G-NADETs.METHODS This cross-sectional retrospective study investigated the relationship between EGMA and NADETs in 134 patients.The duodenum was divided into parts 1(bulb),2(superior duodenal angle to the papilla),and 3(anal side of the papilla to the horizontal part).The effects of gastric acidity and presence of Brunner’s glands were considered.EGMA was divided into types C(no or mild atrophy)and O(severe atrophy).Mucin phenotype expressions in NADETs were divided into gastric,intestinal,gastrointestinal,and unclassifiable.RESULTS When NADETs were classified according to EGMA,105 were classified as type C and 29 as type O.G-NADETs were present in 11.9%(16 cases)of all cases,and all 16 cases were of type C.Among G-NADETs,93.8%(15 cases)were present in part 1 or 2.There was an association between G-NADETs and type C in part 1,and 50.0%(eight of 16 cases)of G-NADETs were associated with a current or previous Helicobacter pylori infection status.Additionally,all eight cases occurred in part 1.CONCLUSION G-NADETs were significantly associated with type C.Gastric acidity and Brunner's gland growth may be associated with G-NADETs.展开更多
BACKGROUND Atrophic gastritis is a precancerous lesion of the stomach.It has been reported that pepsinogen(PG)can reflect the morphology and function of the gastric mucosa,and it is therefore used as a marker for the ...BACKGROUND Atrophic gastritis is a precancerous lesion of the stomach.It has been reported that pepsinogen(PG)can reflect the morphology and function of the gastric mucosa,and it is therefore used as a marker for the early diagnosis of atrophic gastritis.AIM To evaluate the diagnostic value of serum PG for degree of gastric mucosal atrophy in asymptomatic Chinese upon physical examination.METHODS Medical data were collected from subjects who underwent transnasal gastroscopy between October 2016 and October 2018.For each study subject,serum PG levels and presence of Helicobacter pylori(H.pylori)infection were investigated.Pathology was evaluated using the Operative Link for Gastritis Assessment(OLGA)classification and Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)systems.All statistical analyses were carried out using SPSS statistical software.RESULTS A total of 2256 subjects were enrolled and 1922 cases were finally included in the study.Based on the OLGA grading system,the levels of PGI were slightly decreased,while those of PGII were slightly increased.The PGI/PGII ratio(PGR)was reduced with increasing atrophy.The association between PG and OLGA grading was higher compared with that between PG and the OLGIM grading system.Compared with the OLGA-0 group,a statistically significant difference was observed in the mean age of OLGA-Ⅰ,Ⅲ,and Ⅳ groups(P<0.05).In the H.pylori-positive subjects,the PGR levels were notably lower in the OLGA-Ⅰ,Ⅱ,and Ⅲ groups compared with the OLGA-0 group(P<0.05).H.pylori-positive subjects exhibited significantly higher PGI and PGII serum levels and a significantly lower PGR compared with H.pylori-negative patients in different OLGA groups(P<0.05).CONCLUSION Serum PG levels may represent a non-invasive screening marker for gastric mucosal atrophy in asymptomatic subjects.展开更多
文摘BACKGROUND The pathogenesis of non-ampullary duodenal epithelial tumors(NADETs)is not fully understood.NADETs that express gastric-type mucin phenotypes(GNADETs)are noteworthy because of their high malignancy.Gastric foveolar metaplasia,from which G-NADETs originate,protects the duodenal mucosa from gastric acidity.As gastric acid secretion is affected by endoscopic gastric mucosal atrophy(EGMA),we hypothesized that EGMA would be associated with GNADETs.AIM To evaluate the association between EGMA and the occurrence of G-NADETs.METHODS This cross-sectional retrospective study investigated the relationship between EGMA and NADETs in 134 patients.The duodenum was divided into parts 1(bulb),2(superior duodenal angle to the papilla),and 3(anal side of the papilla to the horizontal part).The effects of gastric acidity and presence of Brunner’s glands were considered.EGMA was divided into types C(no or mild atrophy)and O(severe atrophy).Mucin phenotype expressions in NADETs were divided into gastric,intestinal,gastrointestinal,and unclassifiable.RESULTS When NADETs were classified according to EGMA,105 were classified as type C and 29 as type O.G-NADETs were present in 11.9%(16 cases)of all cases,and all 16 cases were of type C.Among G-NADETs,93.8%(15 cases)were present in part 1 or 2.There was an association between G-NADETs and type C in part 1,and 50.0%(eight of 16 cases)of G-NADETs were associated with a current or previous Helicobacter pylori infection status.Additionally,all eight cases occurred in part 1.CONCLUSION G-NADETs were significantly associated with type C.Gastric acidity and Brunner's gland growth may be associated with G-NADETs.
基金Supported by National Natural Science Foundation of China,No.71804161,No.72074188。
文摘BACKGROUND Atrophic gastritis is a precancerous lesion of the stomach.It has been reported that pepsinogen(PG)can reflect the morphology and function of the gastric mucosa,and it is therefore used as a marker for the early diagnosis of atrophic gastritis.AIM To evaluate the diagnostic value of serum PG for degree of gastric mucosal atrophy in asymptomatic Chinese upon physical examination.METHODS Medical data were collected from subjects who underwent transnasal gastroscopy between October 2016 and October 2018.For each study subject,serum PG levels and presence of Helicobacter pylori(H.pylori)infection were investigated.Pathology was evaluated using the Operative Link for Gastritis Assessment(OLGA)classification and Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)systems.All statistical analyses were carried out using SPSS statistical software.RESULTS A total of 2256 subjects were enrolled and 1922 cases were finally included in the study.Based on the OLGA grading system,the levels of PGI were slightly decreased,while those of PGII were slightly increased.The PGI/PGII ratio(PGR)was reduced with increasing atrophy.The association between PG and OLGA grading was higher compared with that between PG and the OLGIM grading system.Compared with the OLGA-0 group,a statistically significant difference was observed in the mean age of OLGA-Ⅰ,Ⅲ,and Ⅳ groups(P<0.05).In the H.pylori-positive subjects,the PGR levels were notably lower in the OLGA-Ⅰ,Ⅱ,and Ⅲ groups compared with the OLGA-0 group(P<0.05).H.pylori-positive subjects exhibited significantly higher PGI and PGII serum levels and a significantly lower PGR compared with H.pylori-negative patients in different OLGA groups(P<0.05).CONCLUSION Serum PG levels may represent a non-invasive screening marker for gastric mucosal atrophy in asymptomatic subjects.
