四分位间距
医学
优势比
入射(几何)
内科学
流行病学
幽门螺杆菌
癌症
胃肠病学
置信区间
光学
物理
作者
Joan Llach,Inmaculada Alonso‐Abreu,A Guerra,Beatriz Peñas,Daniel Rodríguez-Alcalde,Pilar Díez‐Redondo,Joaquín Cubiella,Óscar Murcia,Maite Escalante,Jordi Gratacós‐Ginès,Anna Pocurull,María Daca-Álvarez,Irina Luzko,Ariadna Sánchez,Cristina Herrera‐Pariente,Francesc Balaguer,Sabela Carballal,Ignasi Elizalde,Sergi Castellví‐Bel,Glòria Fernández‐Esparrach,Antoni Castells,Francesc Balaguer,Leticia Moreira
摘要
While clinical practice guidelines for hereditary diffuse gastric cancer are well established, there is no consensus on the approach for familial intestinal gastric cancer (FIGC). In low-incidence gastric cancer (GC) areas such as the United States or most European countries, there are no evidence-based recommendations on endoscopic assessment in FIGC families. We aim to describe the yield of GC surveillance in these families, and to identify epidemiological risk factors for the development of GC and its precursor lesions. This is a multicenter observational study involving nine tertiary Spanish hospitals, in which all individuals fulfilling FIGC criteria who underwent endoscopic surveillance were included between 1991 and 2020. Forty-one healthy individuals of 31 families were recruited. The median number of upper gastrointestinal endoscopies per individual was 3 (interquartile range, IQR, 1-4). The median interval time between tests was 2 years (IQR 1.5-2.5), and the median follow-up was 9 years (IQR 3-14.5). In 18 (43.9%) subjects, a precursor lesion of GC was found during follow-up, and in 2 (4.9%), an early GC was identified, in which curative treatment was offered. Helicobacter pylori (Hp) infection proved to be independently associated with an increased risk of developing precursor lesions or GC, adjusted by age, gender and follow-up, with an Odds Ratio of 6.443 (1.36-30.6, P value .019). We present the first outcomes that support endoscopic surveillance with biopsies and detection of Hp in FIGC families, although the periodicity has yet to be defined.
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