{"title":"京都分类与幽门螺杆菌根除后胃癌发展相关的预测因素:一项前瞻性多中心观察研究。","authors":"Shun Takayama, Osamu Dohi, Ryusuke Horie, Takeshi Yasuda, Tomoko Ochiai, Naoto Iwai, Eiko Imamoto, Tomohisa Takagi, Osamu Handa, Hideyuki Konishi, Takashi Ando, Yuji Naito, Toshiki Takemura, Yoshito Itoh","doi":"10.3390/diagnostics15182376","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background/Objectives</b>: This study aimed to identify specific endoscopic findings associated with the development of GC following successful <i>H. pylori</i> eradication. <b>Methods</b>: This prospective multicenter observational study included patients who underwent annual surveillance endoscopy after successful <i>H. pylori</i> eradication therapy between September 2013 and June 2019. Endoscopic findings were evaluated one year after eradication therapy and analyzed using the Kyoto Classification of Gastritis to identify factors associated with GC development. <b>Results</b>: A total of 465 patients were included, including 49 patients with GC and 416 patients without GC. At the initial endoscopic assessment (median, 0.96 years post-eradication), emergence of map-like redness and invisible regular arrangement of collecting venule (RAC) as independent predictors of GC (map-like redness: hazard ratio [HR], 2.561; 95% confidence interval [CI], 1.362-4.572; <i>p</i> = 0.003; invisible RAC: HR, 3.131; 95% CI, 1.078-9.091; <i>p</i> = 0.036). Patients with map-like redness or invisible RAC showed a significantly higher incidence of GC than those without map-like redness or invisible RAC (<i>p</i> < 0.001 and <i>p</i> < 0.001, respectively). Notably, map-like redness and visible RAC appeared in 13% and 28.4% of cases within the first year after eradication, respectively. <b>Conclusions</b>: Map-like redness and invisible RAC were identified as independent predictors of GC following <i>H. pylori</i> eradication and may serve as early predictive indicators, appearing within one year of successful eradication. This finding underscores the importance of early surveillance endoscopy in identifying patients at elevated risk for GC.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"15 18","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468032/pdf/","citationCount":"0","resultStr":"{\"title\":\"Kyoto Classification-Based Predictive Factors Associated with the Development of Gastric Cancer After <i>Helicobacter pylori</i> Eradication: A Prospective Multicenter Observational Study.\",\"authors\":\"Shun Takayama, Osamu Dohi, Ryusuke Horie, Takeshi Yasuda, Tomoko Ochiai, Naoto Iwai, Eiko Imamoto, Tomohisa Takagi, Osamu Handa, Hideyuki Konishi, Takashi Ando, Yuji Naito, Toshiki Takemura, Yoshito Itoh\",\"doi\":\"10.3390/diagnostics15182376\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background/Objectives</b>: This study aimed to identify specific endoscopic findings associated with the development of GC following successful <i>H. pylori</i> eradication. <b>Methods</b>: This prospective multicenter observational study included patients who underwent annual surveillance endoscopy after successful <i>H. pylori</i> eradication therapy between September 2013 and June 2019. Endoscopic findings were evaluated one year after eradication therapy and analyzed using the Kyoto Classification of Gastritis to identify factors associated with GC development. <b>Results</b>: A total of 465 patients were included, including 49 patients with GC and 416 patients without GC. At the initial endoscopic assessment (median, 0.96 years post-eradication), emergence of map-like redness and invisible regular arrangement of collecting venule (RAC) as independent predictors of GC (map-like redness: hazard ratio [HR], 2.561; 95% confidence interval [CI], 1.362-4.572; <i>p</i> = 0.003; invisible RAC: HR, 3.131; 95% CI, 1.078-9.091; <i>p</i> = 0.036). Patients with map-like redness or invisible RAC showed a significantly higher incidence of GC than those without map-like redness or invisible RAC (<i>p</i> < 0.001 and <i>p</i> < 0.001, respectively). Notably, map-like redness and visible RAC appeared in 13% and 28.4% of cases within the first year after eradication, respectively. <b>Conclusions</b>: Map-like redness and invisible RAC were identified as independent predictors of GC following <i>H. pylori</i> eradication and may serve as early predictive indicators, appearing within one year of successful eradication. This finding underscores the importance of early surveillance endoscopy in identifying patients at elevated risk for GC.</p>\",\"PeriodicalId\":11225,\"journal\":{\"name\":\"Diagnostics\",\"volume\":\"15 18\",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12468032/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diagnostics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3390/diagnostics15182376\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/diagnostics15182376","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景/目的:本研究旨在确定成功根除幽门螺杆菌后与胃癌发展相关的特定内镜检查结果。方法:这项前瞻性多中心观察性研究纳入了2013年9月至2019年6月期间成功根除幽门螺旋杆菌治疗后每年进行内窥镜检查的患者。内镜检查结果在根除治疗一年后进行评估,并使用京都胃炎分类法进行分析,以确定与胃癌发展相关的因素。结果:共纳入465例患者,其中胃癌49例,非胃癌416例。在最初的内镜评估中(中位数,根除后0.96年),图样红的出现和收集小静脉不可见的规则排列(RAC)作为GC的独立预测因子(图样红:风险比[HR] 2.561; 95%可信区间[CI] 1.362-4.572; p = 0.003;不可见RAC: HR 3.131; 95% CI 1.078-9.091; p = 0.036)。伴有地图样发红或不可见RAC的患者胃癌发生率明显高于无地图样发红或不可见RAC的患者(p < 0.001和p < 0.001)。值得注意的是,13%和28.4%的病例在根除后的一年内分别出现了地图样红肿和可见RAC。结论:图谱样发红和不可见RAC被确定为幽门螺杆菌根除后胃癌的独立预测指标,可能作为早期预测指标,在成功根除后一年内出现。这一发现强调了早期内镜监测在鉴别胃癌高危患者中的重要性。
Kyoto Classification-Based Predictive Factors Associated with the Development of Gastric Cancer After Helicobacter pylori Eradication: A Prospective Multicenter Observational Study.
Background/Objectives: This study aimed to identify specific endoscopic findings associated with the development of GC following successful H. pylori eradication. Methods: This prospective multicenter observational study included patients who underwent annual surveillance endoscopy after successful H. pylori eradication therapy between September 2013 and June 2019. Endoscopic findings were evaluated one year after eradication therapy and analyzed using the Kyoto Classification of Gastritis to identify factors associated with GC development. Results: A total of 465 patients were included, including 49 patients with GC and 416 patients without GC. At the initial endoscopic assessment (median, 0.96 years post-eradication), emergence of map-like redness and invisible regular arrangement of collecting venule (RAC) as independent predictors of GC (map-like redness: hazard ratio [HR], 2.561; 95% confidence interval [CI], 1.362-4.572; p = 0.003; invisible RAC: HR, 3.131; 95% CI, 1.078-9.091; p = 0.036). Patients with map-like redness or invisible RAC showed a significantly higher incidence of GC than those without map-like redness or invisible RAC (p < 0.001 and p < 0.001, respectively). Notably, map-like redness and visible RAC appeared in 13% and 28.4% of cases within the first year after eradication, respectively. Conclusions: Map-like redness and invisible RAC were identified as independent predictors of GC following H. pylori eradication and may serve as early predictive indicators, appearing within one year of successful eradication. This finding underscores the importance of early surveillance endoscopy in identifying patients at elevated risk for GC.
DiagnosticsBiochemistry, Genetics and Molecular Biology-Clinical Biochemistry
CiteScore
4.70
自引率
8.30%
发文量
2699
审稿时长
19.64 days
期刊介绍:
Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.