| Objective:To explore the clinical characteristics and possible ri sk factors of gastric xanthelasma,and analyze the diagnost ic value of gastric xanthelasma for atrophic gastritis and intestinal metaplasia.Methods:A total of 200 patients with gastric xanthelasma who met the inclusion criteria under gastroscopy in our hospital from December 1,2017 to November 30,2020 were collected.A total of 200 patients with gastric xanthelasma who were not found under gastroscopy in the same period and with other upper gastrointestinal diseases were randomly selected and set as the non-gastric xanthelasma group.Collect the clinical data,endoscopic and pathological results of the two groups of patients,analyze the location,size,number and detection rate of gastric precancerous lesions under endoscopy of gastric xanthelasma,and compare the age,gender,BMI,past history of the two groups of patients Medical history(diabetes,hypertension,hyperlipidemia,smoking history,drinking history),related serological indicators(fasting blood glucose,blood lipids,blood routine,CEA,CA199),Hp infection and atrophic gastritis,intestinal metaplasia,For related risk factors such as dysplasia and gastric cancer,multivariate logistic regression analysis was performed on the results of single-factor comparisons with differences,to explore the main risk factors related to the onset of gastric xanthelasma,and to analyze gastric xanthelasma and atrophic gastritis and intestinal metaplasia Relevance.Results:1.The incidence rate of gastric xanthelasma was 3.17%,which was mainly single,accounting for 65.50% of the total;the size of the lesion ranges from 2-11 mm,with 2-3mm being the most common,accounting for 68.53%;the site of incidence was gastric antrum The most common,accounting for 37.93% of the total.2.Comparing the age,drinking history,LDL,NLR and Hp infection,atrophic gastritis,intestinal metaplasia and gastric cancer between the two groups,the difference was statistically significant(P<0.05).Among them,when the age is ≥50 years,the incidence of gastric xanthelasma was significantly increased,accounting for 84.00% of the total number,and the predominant population was between 50-70 years old;the Hp infection rate of patients in the gastric xanthelasma group was significantly higher than that of non-gastric macular In the tumor group(72.50% vs.49.00%,P<0.05),the detection rates of atrophic gastritis,intestinal metaplasia,and gastric cancer were also significantly higher than those of non-gastric xanthelasma,which were 44.50% vs.20.50%,23.50% vs.4.00%,6.50% to 1.50%(P<0.05),and different degrees of atrophic gastritis and intestinal epithelialization were different in survival(P<0.05);the gender,smoking history,diabetes,hypertension,hyperlipidemia of the two groups There were no statistical differences in indicators such as disease,BMI,fasting blood glucose,total cholesterol,triglycerides,high-density lipoprotein,gastric polyps,reflux esophagitis,and peptic ulcer(P>0.05).3.Multivariate logistic regression analysis showed that age(OR=1.02,95%CI: 1.00-1.04,P<0.05),drinking history(OR=2.49,95%CI: 1.11-5.62,P<0.05),Hp Infection(OR=1.78,95%CI: 1.11-2.87,P<0.05),atrophic gastritis(OR=2.60,95%CI:1.57-4.30,P<0.05),intestinal metaplasia(OR=7.12,95 %CI:3.16-16.05,P<0.05)and gastric cancer(OR=5.32,95%CI:1.39-20.42,P<0.05)are significantly related to gastric xanthelasma,which were independent risk factors for the onset of gastric xanthelasma.4.There may be no correlation between the number of gastric xanthelasma lesions,age and Hp infection(P>0.05).5.The sensitivity of gastric xanthoma to the diagnosis of atrophic gastritis and intestinal metaplasia was 68.46% and85.45%,the specificity was 58.89% and 55.65%,respectively,the positive predictive value was 44.50%,23.50%,and the negative predictive value They were 79.50% and 96.00%,and the accuracy was 62.00% and 59.75%,respectively.The area under the ROC curve for the diagnosis of the two diseases were 0.639±0.029(P<0.05)and 0.708±0.034(P<0.05).Conclusions:1.The incidence of gastric xanthelasma is 3.17%,and the predominant population is ≥50 years old,with single lesions2-3mm in size,and the gastric antrum is the most common site.2.Age,drinking history,Hp infection,atrophic gastritis,intestinal metaplasia and gastric cancer are significantly related to gastric xanthelasma,which are independent risk factors for the onset of gastric xanthelasma.3.Xanthelasma of the stomach has a certain predictive value for atrophic gastritis and intestinal metaplasia,and it has a higher predictive value for intestinal metaplasia. |
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