The Research Of The Correlation Between Gastric Xanthoma And Stomach Precancerous Lesion

Background:The clinical significance of the gastric xanthelasma has got increasing attention in recent years.Xanthelasma mainly appears at the antrum of stomach while infrequently at esophagus or duodenum,and the main performance is yellow or white nodular during endoscopy examination.The purpose of this study is to evaluate whether gastric xanthelasma is an indicator of gastric precancerous lesions such as advanced atrophic gastritis and intestinal metaplasia by analyzing the difference of detective rate of gastric cancer,atrophic gastritis,and intestinal metaplasia between xanthelasma patient and control group in the past 6 years.Methods:We choose the patients with gastric xanthelasma found in endoscopy,in which 448 patients are male and 426 are female,and the patients without xanthelasma for control group,in which 269 are male and 276 are female,during January 1,2011 to November 25,2016.The location and quantity of xanthelasma,the age and gender of patient would be recorded.Whether the detection rate of gastric mucosa lesion such as H.pylori infection,erosion,ulcer,atrophic gastritis,intestinal metaplasia or intraepithelial neoplasia would be prepare between xanthelasma patients and control group.The diagnosis of mucosa lesion took biopsy as the standard.Results:The detective rate of H.pylori and gastric cancer of xanthelasma patients showed no significant difference compared with control group.The xanthelasma and the control group showed no significant difference in sexuality.The xanthelasma and the control group showed significant difference in age.The xanthelasma group had significantly higher detective rate of intestinal metaplasia than the control group,and the severity of intestinal metaplasia was significantly higher in the xanthelasma group than the control group.Similarly,the xanthelasma group had significantly higher detective rate of atrophic gastritis than the control group,and the severity of atrophic gastritis was significantly higher than the control group.Among the xanthelasma group,xanthelasmas mainly appeared at the gastric antrum with few appeared at esophagus or duodenum.The detective rate of gastric cancer had no significant difference between different locations of xanthelasmas.Patients with multiple xanthelasmas and patients with single xanthelasma had no significant difference in detective rate of intestinal metaplasia or atrophic gastritis.However,the severity of intestinal metaplasia and atrophic gastritis was significantly higher in the patients with multiple xanthelasmas than the patients with single xanthelasma.Conclusions:The detective rate of H.pylori and gastric cancer of xanthelasma patients showed no significant difference compared with control group.Further analysis showed that xanthelasma group had significantly higher detective rate of intestinal metaplasia and atrophic gastritis than the control group,and the severity of intestinal metaplasia and atrophic gastritis was significantly higher than the control group.Among the xanthelasma group,although patients with multiple xanthelasmas and patients with single xanthelasma had no significant difference in detective rate of intestinal metaplasia or atrophic gastritis.But the severity of intestinal metaplasia and atrophic gastritis was significantly higher in the patients with multiple xanthelasmas than the patients with single xanthelasma.Considering the intestinal metaplasia is recognized as gastric precancerous lesion,while atrophic gastritis being recognized as one of gastric precancerous conditions,appearance of xanthelasma may a marker which shows the severity of mucosa lesion.Biopsy may be more necessary for xanthelasma patient.