위축성 위염과 화생성 위염의 전구 병변으로서 결절성 위염의 의의
Nodular Gastritis as a Precursor Lesion of Atrophic and Metaplastic Gastritis
김영중, 이선영, 양호준, 김정환, 성인경, 박형석,
소속 상세정보
김영중 ( Kim Young-Joong )
건국대학교 의학전문대학원 내과학교실
이선영 ( Lee Sun-Young )
건국대학교 의학전문대학원 내과학교실
양호준 ( Yang Ho-Jun )
건국대학교 의학전문대학원 내과학교실
김정환 ( Kim Jeong-Hwan )
건국대학교 의학전문대학원 내과학교실
성인경 ( Sung In-Kyung )
건국대학교 의학전문대학원 내과학교실
박형석 ( Park Hyung-Seok )
건국대학교 의학전문대학원 내과학교실
Abstract
Background/Aims: Chronic atrophic gastritis (CAG) and metaplastic gastritis (MG) are precancerous conditions of Helicobacter pylori (H. pylori)-related gastric cancer. This study aimed to identify the characteristics of nodular gastritis (NG) showing CAG or MG after nodule regression.
Methods: H. pylori-infected patients with NG were included after upper gastrointestinal endoscopy. Patients were excluded if their latest endoscopy had been performed ≤36 months after the initial diagnosis of NG. Small-granular-type NG was defined as the condition with 1-2 mm regular subepithelial nodules. Large-nodular-type NG was defined as those with 3-4 mm, irregular subepithelial nodules. The endoscopic findings after nodule regression were recorded.
Results: Among the 97 H. pylori-infected patients with NG, 61 showed nodule regression after a mean follow-up of 73.0±22.0 months. After nodule regression, 16 patients showed a salt-and-pepper appearance and/or transparent submucosal vessels, indicating CAG. Twenty-nine patients showed diffuse irregular elevations and/or whitish plaques, indicating MG. Sixteen patients with other endoscopic findings (14 normal, one erosive gastritis, and one chronic superficial gastritis) showed a higher proportion of H. pylori eradication (12/16, 75.0%) than those in the CAG group (5/16, 31.3%) and MG group (6/29, 20.7%; p=0.001). Patients with small-granular-type NG tended to progress toward CAG (14/27, 51.9%), whereas those with large-nodular-type NG tended to progress toward MG (25/34, 73.5%; p<0.001).
Conclusions: In patients with a persistent H. pylori infection, NG tended to progress to CAG or MG when the nodules regressed. Small-granular-type NG tended to progress to CAG, whereas large-nodular-type NG tended to progress to MG.
키워드
Gastritis; Lymphoid tissue; Atrophy; Metaplasia
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