The Relationship Between Gastric Xanthoma And Chronic Atrophic Gastritis, Intestinal Metaplasia And Gastric Cancer

Background and Objective:With the universal of gastroscopy and the progress of gastroscopy,the discovery and diagnosis of various gastroscopy are becoming more and more important.Gastric xanthelasma（Gastric xanthoma,GX）is also called xanthelasmata or lipid Island,endoscopic performance of small yellowish nodular bulge or plaque mucosa injury,histology showed foam mucosa lamina propria containing neutral fats ranging from the size of the cell cluster characteristics were considered to be a benign lesion rare.Helicobacter pylori（Helicobacter pylori,Hp）is a gram-negative,microaerobic,spirillum,which is curved,and is colonized in different regions of human gastrointestinal tract by its flagellum,which is closely related to the occurrence and development of various gastrointestinal diseases.Chronic atrophic gastritis（Chronic atrophic gastritis,CAG）also known as atrophic gastritis,is a kind of gastric mucosal epithelium and gland atrophy,reduced gastric mucosal thinning,submucosa thickening or pyloric gland metaplasia and intestinal metaplasia,or chronic diseases of digestive system is characteristic of atypical hyperplasia.Gastric intestinal metaplasia（Gastric intestinal metaplasia,GIM）is the phenomenon that the epithelium of the gastric mucosa is replaced by the intestinal type of the intestinal epithelium.Intestinal metaplasia is often combined with chronic gastritis,especially chronic atrophic gastritis.Helicobacter pylori infection and gastrointestinal metaplasia are closely related to gastric cancer.Recent studies have shown that gastric xanthoma is associated with precancerous lesions and gastric cancer,which may be a predictor of gastric cancer.This article is to study the relationship between gastric xanthoma and helicobacter pylori infection,chronic atrophic gastritis,intestinal metaplasia and gastric cancer.Methods:Inpatient and outpatient were selected from December 2011 to December 2017in the First Affiliated Hospital of Zhengzhou University Department of gastroenterology clinic of 647 cases of gastric xanthoma patients,male 345 cases,female 302 cases,age 38⁷3,average（61.46±6.34）years old,randomly selected the same period 545 cases of gastric xanthelasma with other patients with digestive system diseases as a control group,270 cases were male,275 were female,age 35⁷9years,average（59.78±7.80）years old,compared two groups of patients with age,gender and other general information,there was no statistically significant difference（P>0.05）.¹³C or ¹⁴C breath test was used to detect whether Hp infection was combined.The difference of Hp infection rate between the two groups was analyzed.Meanwhile,the incidence of atrophic gastritis,intestinal metaplasia and gastric cancer in two groups under gastroscopy were analyzed.SPSS 20 statistical software was used to analyze the data.Quantitative data were expressed in（x±s）,T test was used.Qualitative data were analyzed by chi square test,and multivariate Logistic regression analysis was used to analyze risk factors for gastric xanthoma.P<0.05 was statistically significant.Results:1.647 cases of gastric xanthoma group Hp infection rate is higher than the 545cases of gastric xanthelasma group（60%vs 51.37%,P=0.003）;the incidence of chronic atrophic gastritis and gastric xanthoma group（19.94%vs 13.76%,P=0.005）,the incidence of intestinal metaplasia（47%vs 31%,P<0.010）incidence.And gastric cancer（3.40%vs 1.47%,P=0.034）were higher than those in non gastric xanthelasma group.The difference was statistically significant（P<0.05）.2.Gastric xanthelasma lesions were solitary accounted for 72.02%（466/647）,including 269 cases in 117 cases of gastric antrum,gastric body and gastric fundus in26 cases,38 cases of gastric cardia,gastric angle in 16 cases,two parts accounted for13.76%（89/647）;Hp infection and incidence rate of gastric cancer and gastric xanthoma multiple or not independent（P>0.05）,multiple patients than in single patients had a higher incidence of atrophic gastritis（33.15%vs 10.66%）and higher incidence of intestinal metaplasia（62.98%vs 50.86%）,the difference was statistically significant（P<0.05）.3.Hyperlipidemia,hyperglycemia,hypertension,Hp infection,chronic atrophic gastritis,intestinal metaplasia and combined gastric cancer as independent variables,multiple factor Logistic regression analysis of the risk factors of gastric xanthoma,regression analysis of multiple factors:hyperlipidemia,hyperglycemia,and hypertension 3 There was no statistical significance in independent variables（P>0.05）,which is not a risk factor for gastric xanthoma.The 4 independent variables of Helicobacter pylori infection,chronic atrophic gastritis,intestinal metaplasia and gastric cancer were statistically significant（P<0.05）,which were the risk factors for the occurrence of gastric xanthoma.Conclusion:1.The incidence of Hp infection,chronic atrophic gastritis and gastric cancer in the gastric xanthoma group were higher than those in the non gastric xanthoma group.2.Single gastric xanthoma is common.Hp infection has nothing to do with gastric xanthoma.Multiple patients have higher incidence of atrophic gastritis and higher intestinal metaplasia than single patients.Gastric cancer is not associated with multiple gastric xanthoma.3.Helicobacter pylori infection,chronic atrophic gastritis,intestinal metaplasia and gastric cancer are the risk factors for the occurrence of gastric xanthoma.