923例胃息肉的临床病理及内镜下特征分析研究

Analysis of Clinicopathological and Endoscopic Characteristics of 923 Cases of Gastric Polyps

摘要: 目的：分析不同病理类型胃息肉的临床病理特征，了解本地区胃息肉的流行病学、临床及内镜下特点。方法：收集2019年9月1日~2020年8月31日于青岛大学附属医院消化内科住院并行胃镜活检诊断为胃息肉的患者，回顾性分析患者年龄、性别、内镜特征及病理报告等数据。结果：共检出胃息肉患者923例，男324例(35.10%)，女599例(64.90%)，男女比例为：1:1.85。胃息肉最常出现的症状为腹痛(38.72%)、腹胀(17.27%)、反酸(10.08%)，且症状多单一发作(60.46%)。不同类型胃息肉的构成比随年龄增长均呈增加趋势。所有胃息肉中，胃息肉的好发部位为胃底(28.49%)和胃体(58.36%)，胃底腺息肉最常分布在胃体、胃底，腺瘤性息肉、炎性息肉、增生性息肉分布则以胃窦、胃体为主(p < 0.05)。93.06%的胃息肉最大直径≤1 cm，合并萎缩及肠化共162例(17.55%)。胃息肉患者合并幽门螺杆菌感染(Helicobacter pylori, HP) 96例，阳性率为10.40%，胃底腺息肉的HP感染检出率明显低于其他组别(P < 0.05)。结论：胃底腺息肉和增生性息肉是目前最常见的2种息肉类型，鉴于HP在2种息肉中的作用截然不同，对于息肉的处理需结合患者息肉类型制定个体化诊疗策略。≥50岁患者息肉检出率明显升高，高癌变风险的腺瘤性息肉在50岁以上患者也更常见，因此对≥50岁患者胃息肉的检出及病理类型需加以重视。

Abstract: Objective: The objective is to analyze the clinicopathological characteristics of different pathological types of gastric polyps, to understand the epidemiological, clinical and endoscopic characteristics of gastric polyps in the region. Methods: Patients hospitalized in our center and diagnosed with gastric polyps by gastroscopic biopsy from September 1, 2019 to August 31, 2020 were collected. The patient’s age, gender, endoscopic characteristics and pathological reports were retrospectively analyzed. Results: A total of 923 patients with gastric polyps were detected, There were 324 males (35.10%), and 599 females (64.90%). The male to female ratio was 1:1.85. The most common symptoms of gastric polyps were abdominal pain (38.72%), bloating (17.27%), and acid reflux (10.08%), and the symptoms are usually solitary (60.46%). The composition ratio of different types of gastric polyps showed an increasing trend with age. Among all gastric polyps, the most common sites for gastric polyps are the fundus (28.49%) and the body (58.36%) of the stomach. The fundus gland polyps are most commonly distributed in gastric fundus and gastric body. Adenomatous polyps, inflammatory polyps, and hyperplastic polyps are mainly distributed in gastric antrum and gastric body (P < 0.05). 93.06% of gastric polyps had a maximum diameter of ≤1 cm, and a total of 162 cases (17.55%) were combined with atrophy and intestinal metaplasia. There were 96 cases of gastric polyps with Helicobacter pylori (HP) infection. The positive rate was 10.40%. The HP infection detection rate of gastric polyps was significantly lower than other groups (P < 0.05). Conclusion: Fundus gland polyps and hyperplastic polyps are currently the two most common types of polyps. In view of the different roles of HP in the two types of polyps, it is necessary to develop individualized diagnosis and treatment strategies based on the types of polyps in the treatment. The detection rate of polyps in patients ≥50 years old is significantly higher, and adenomatous polyps with high cancer risk are more common in patients over 50 years old. Therefore, attention should be paid to the detection and pathological types of gastric polyps in patients ≥50 years of age.