The Study On The Family History Of Gastric Cancer And Helicobacter Pylori Infection In Chronic Gastritis

Objective:To investigate whether there is family history of gastric cancer and H.pylori infection in chronic gastritis patients,and explore the relationship between the family history of gastric cancer and H.pylori infection,and futher explore their relationship with the degree of inflammation,activity,atrophy and intestinal metaplasia,and pathological changes of gastric mucosa among different relatives of gastric cancer.It will provide scientific basis for follow-up and monitoring of chronic gastritis patients,especially the patients with family history of gastric cancer.Methods:A questionnaire was conducted for patients diagnosed with chronic gastritis by gastroscopy,pathological examination and¹³C urea breath test,the indices included general information,smoking,drinking,the family history of gastric cancer and H.pylori infection.To analyze the occurrence of the family history of gastric cancer and its relationship with H.pylori infection,and their association with the degree of inflammation,activity,atrophy,intestinal metaplasia in chronic gastritis,and analyze pathological changes of gastric mucosaamong different relatives of gastric cancer.Statistical analysis with the statistical software.Results:1.A total of 331 patients,181（54.7%）were with family history of gastric cancer,125（69.1%）were the first-degree relatives and 56（30.9%）were second-degree relatives.2.The H.pylori infection rate in chronic gastritis patients with family history of gastric cancer was 74.0%,and that in those without family history of gastric cancer was60.7%,which was significantly higher than those patients without family history of gastric cancer.3.The pathological features of chronic gastritis patients:degree of inflammation:mild（20.6%）,moderate（44.1%）,severe（35.3%）;active inflammation accounted for85.2%,of which mild（48.7%）,moderate（31.1）%),Severe（5.4%）;Atrophy accounted for 16.3%,of which mild（1.5%）,moderate（11.5%）,severe（3.3%）;intestinal metaplasia accounted for 53.2%,of which mild（36.3%）,Moderate（10.9%）,Severe（6.0%）.The results of regression analysis showed that smoking,drinking and H.pylori infection were risk factors for inflammation of chronic gastritis.<60 years old,smoking and H.pylori infection were risk factors for inflammatory activity.The family history of gastric cancer and H.pylori infection were risk factors for atrophic.gender,family history of gastric cancer and H.pylori infection were risk factors for intestinal metaplasia.4.The pathological features of patients with family history of gastric cancer:first and second degree relatives:degree of inflammation:mild（15.2%VS 19.6%）,moderate（52.0%VS 33.9%）,severe（32.8%VS 46.4%）;activity:no activity（14.4%VS 19.6%）,mild（52.8%VS 39.3%）,moderate（28.0%VS 33.9%）,severe（4.8%VS 7.1%）;atrophy:no atrophy（72.0%VS 91.1%）,mild（1.6%VS 1.8%）,moderate（20.8%VS 7.1%）,Severe（5.8%VS 0.0%）;Intestinal metaplasia:no intestinal metaplasia（35.2%VS 55.4%）,mild（37.6%VS 37.5%）,moderate（16.0%VS 5.4%）,severe（11.2%VS 1.8%）.The results showed that first-degree relatives of gastric cancer have more atrophic gastric mucosa and intestinal metaplasia.Conclusion:1.Chronic gastritis patients with the family history of gastric cancer are prone to H.pylori infection.2.The family history of gastric cancer is the risk factor for gastric mucosal atrophy and intestinal metaplasia.H.pylori infection is an important influencing factor of gastric mucosal inflammation,activity,atrophy and intestinal metaplasia,and both have synergistic effects on gastric mucosal damage.3.First-degree relatives of chronic gastritis patients with family history of gastric cancer have more atrophic gastric mucosa and intestinal metaplasia compared to the second-degree relatives.However,there was no significant difference in H.pylori infection between the two groups.