다발성 위용종의 조직학적 분류에 따른 위험인자: 전향적 코호트 연구
Risk Factors of Multiple Gastric Polyps according to the Histologic Classification: Prospective Observational Cohort Study
정찬영, 김나영, 이혜승, 윤혁, 신철민, 박영수, 김진욱, 이동호,
소속 상세정보
정찬영 ( Jeong Chan-Young )
분당서울대학교병원 내과
김나영 ( Kim Na-Young )
분당서울대학교병원 내과
이혜승 ( Lee Hye-Seung )
분당서울대학교병원 병리과
윤혁 ( Yoon Hyuk )
분당서울대학교병원 내과
신철민 ( Shin Cheol-Min )
분당서울대학교병원 내과
박영수 ( Park Young-Soo )
분당서울대학교병원 내과
김진욱 ( Kim Jin-Wook )
분당서울대학교병원 내과
이동호 ( Lee Dong-Ho )
분당서울대학교병원 내과
Abstract
Background/Aims: The aim of this study was to determine the risk factors of multiple gastric polyps according to the histological classification of gastric polyps.
Methods: Subjects with multiple gastric polyps (at least three) during endoscopy were enrolled prospectively. They were assigned to a fundic gland polyp (FGP) group and hyperplastic polyp (HP) group based on a histological classification of gastric polyps. Helicobacter pylori (H. pylori) was confirmed by its histology. Serum gastrin was measured using the radioimmunoassay method. A questionnaire was taken regarding the intake of proton pump inhibitor and nonsteroidal anti-inflammatory drugs, alcohol, smoking history, and diet.
Results: Among the 60 subjects enrolled from 2015 to 2018 at Seoul National University Bungdang Hospital, 47 and 13 subjects were assigned to the FGP and HP groups, respectively. The H. pylori infection rate was 12.8% in the FGP group, which is lower than that in the HP group (69.2%, p<0.001). The gastrin level was higher in the HP group (194.7 pg/dL, range 50.6-387.8 pg/dL) than in the FGP group (57.4 pg/dL, range 24.8-79.0 pg/dL) (p=0.007). Histologically, neutrophil infiltration in the antrum and body of the stomach were higher in the HP group than in the FGP group (p=0.022 and p=0.030, respectively). In contrast, monocyte infiltration in the antrum and body of the stomach were higher in the FGP group than in the HP group (p=0.018 and p<0.001, respectively).
Conclusions: HPs arise from inflammation caused by H. pylori. On the other hand, the FGP was not associated with H. pylori or environmental factors.
키워드
Gastric polyps; Helicobacter pylori; Proton pump inhibitors; Gastrin
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