| Objective: To analyze the clinical features, endoscopic performances and pathological of low-grade gastric intraepithelial neoplasia(LGIN), and Summarize its clinical features, so as to provide some references for clinical work and to elevate the detection of gastric low-grade dysplasia.Methods: The subjects who pathologically diagnosed with LGIN for the first time by endoscopy and gastric biopsy in Endoscopy center of Fujian provincial hospital between 2011 and 2013 were recruited, excluding the one who diagnosed with gastric high-grade dysplasia(HGD), gastric carcinoma and other metastatic tumors, underwent endoscopic mucosal resection(EMR) or endoscopic submucosal dissection(ESD), postoperative of gastric cancer and data not whole. In total,452 LGIN lesions were retrospectively studied. all patients were Collected with clinical data and endoscopic features, such as age, gender, endoscopic presentations, location in stomach, infection with Helicobacter pylori, intestinal metaplasia(IM) and gastric atrophy(GA),then analyzed their relationships and explored the risk factors of LGIN with IM.Results: LGIN was most frequently detected in male and the age between 51 to 60 years(35.6%),the sex ratio is 1.6:1,all ages had no difference in gender(P>0.05); LGIN was mostly located in distal stomach( gastric antrum and gastric angle),the rate was 85.2%; Endoscopic presentations of LGIN were diverse and gastric mucosal membrane coarse was most frequently seen(38.7%), location and endoscopic presentations were different in age(P < 0.05);LGIN with IM was 368(81.4%),which was frequently seen in focus with mucosal membrane coarse(90.3%), for the location, it was more frequently detected in gastric angle, which accounted for 95%,it was different in location and endoscopic presentations(P < 0.05);LGIN with GA was 72(15.9%),which was more seen at the age 51 to 60(21.1%) and cardia fundus(28%),the didderences were statistical significance((P < 0.05); The people with H. pylori infection was 321(71%),different locations and endoscopic presentations were different in H. pylori infection, the rate of H. pylori infection was significantly higher in patients with LGIN at the gastric body(88.1%) and ulceration(81.5%),in addition, it was more detected in LGIN with IM and GA, in 91.7% and 75.8%, respectively, all P < 0.05.Multivariate analysis indicated that age, location of the lesions, endoscopic presentations and Hp infection were the risk factors of LGIN with IM.The people age 360 was 2.6 times higher in risk than age￡50 years; Endoscopic presentation with mucosal membrane coarse, hyperplasia, ulceration was higher in risk than normal mucosae, the odds ratios(ORs) is 9.6,7.5 and 6.7, respectively. The gastric antrum and angle were 16 times,4.6times higher in risk than cardia fundus, respectively; Besides, Hp positive was 3.6 times more than Hp negative.Conclusion: There were difference in location of lesions, endoscopic presentations and gastric atrophy of LGIN patients at different ages; the rate of LGIN patients with IM, GA and Hp infection were different at different locations and endoscopic presentations. the rate of H. pylori infection was significantly different between patients with IM and GA.The age, location of lesions, endoscopic presentations and Hp infection were the risk factors of LGIN with IM, in which age more than 60 years, with macroscopic lesions, gastric antrum and gastric angle, Hp positive were more risk than the patients age less than 50 years,normal mucosae, cardia fundus and Hp negative. Therefore, the endoscopic physicians should pay more attentions to these patients for biopsy, so as to elevate the detection of LGIN with IM, then it would reduce the incidence of early gastric cancer(EGC) by regularly follow-up and timely intervention. |
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