Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Non-atrophic gastric mucosa is an independently associated factor for superficial non-ampullary duodenal epithelial tumors: a multicenter, matched, case-control study

  • Azusa Kawasaki (Department of Gastroenterology, Ishikawa Prefectural Central Hospital) ;
  • Kunihiro Tsuji (Department of Gastroenterology, Ishikawa Prefectural Central Hospital) ;
  • Noriya Uedo (Department of Gastrointestinal Oncology, Osaka International Cancer Institute) ;
  • Takashi Kanesaka (Department of Gastrointestinal Oncology, Osaka International Cancer Institute) ;
  • Hideaki Miyamoto (Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University) ;
  • Ryosuke Gushima (Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University) ;
  • Yosuke Minoda (Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University) ;
  • Eikichi Ihara (Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University) ;
  • Ryosuke Amano (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Kenshi Yao (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Yoshihide Naito (Department of Gastroenterology, Fukui Prefectural Hospital) ;
  • Hiroyuki Aoyagi (Department of Gastroenterology, Fukui Prefectural Hospital) ;
  • Takehiro Iwasaki (Department of Gastroenterology, Kochi Red Cross Hospital ) ;
  • Kunihisa Uchita (Department of Gastroenterology, Kochi Red Cross Hospital ) ;
  • Hisatomi Arima (Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University) ;
  • Hisashi Doyama (Department of Gastroenterology, Ishikawa Prefectural Central Hospital)
  • Received : 2022.01.19
  • Accepted : 2022.04.27
  • Published : 2023.01.30
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Abstract

Background/Aims: The etiology of superficial non-ampullary duodenal epithelial tumors (SNADETs) remains unclear. Recent studies have reported conflicting associations between duodenal tumor development and Helicobacter pylori infection or endoscopic gastric mucosal atrophy. As such, the present study aimed to clarify the relationship between SNADETs and H. pylori infection and/or endoscopic gastric mucosal atrophy. Methods: This retrospective case-control study reviewed data from 177 consecutive patients with SNADETs who underwent endoscopic or surgical resection at seven institutions in Japan over a three-year period. The prevalence of endoscopic gastric mucosal atrophy and the status of H. pylori infection were compared in 531 sex- and age-matched controls selected from screening endoscopies at two of the seven participating institutions. Results: For H. pylori infection, 85 of 177 (48.0%) patients exhibited SNADETs and 112 of 531 (21.1%) control patients were non-infected (p<0.001). Non-atrophic mucosa (C0 to C1) was observed in 96 of 177 (54.2%) patients with SNADETs and 112 of 531 (21.1%) control patients (p<0.001). Conditional logistic regression analysis revealed that non-atrophic gastric mucosa was an independent risk factor for SNADETs (odds ratio, 5.10; 95% confidence interval, 2.44-8.40; p<0.001). Conclusions: Non-atrophic gastric mucosa, regardless of H. pylori infection status, was a factor independently associated with SNADETs.

Keywords

Acknowledgement

The authors thank H. Nikki March, PhD, from the Edanz Group (https://en-author-services.edanz.com/ac) for editing the draft of this manuscript.

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