Clinical Endoscopy

  • 제57권1호
  • /
  • Pages.65-72
  • /
  • 2024
  • /
  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Association between occurrence of multiple white and flat elevated gastric lesions and oral proton pump inhibitor intake

  • Rino Hasegawa (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Kenshi Yao (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Takao Kanemitsu (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Hisatomi Arima (Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University) ;
  • Takayuki Hirase (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Yuuya Hiratsuka (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Kazuhiro Takeda (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Kentaro Imamura (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Kensei Ohtsu (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Yoichiro Ono (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Masaki Miyaoka (Department of Endoscopy, Fukuoka University Chikushi Hospital) ;
  • Takashi Hisabe (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Toshiharu Ueki (Department of Gastroenterology, Fukuoka University Chikushi Hospital) ;
  • Hiroshi Tanabe (Department of Pathology, Fukuoka University Chikushi Hospital) ;
  • Atsuko Ohta (Department of Pathology, Fukuoka University Chikushi Hospital) ;
  • Satoshi Nimura (Department of Pathology, Fukuoka University Chikushi Hospital)
  • 투고 : 2022.09.07
  • 심사 : 2022.11.27
  • 발행 : 2024.01.30
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초록

Background/Aims: Multiple white and flat elevated lesions (MWFL) that develop from the gastric corpus to the fornix may be strongly associated with oral antacid intake. Therefore, this study aimed to determine the association between the occurrence of MWFL and oral proton pump inhibitor (PPI) intake and clarify the endoscopic and clinicopathological characteristics of MWFL. Methods: The study included 163 patients. The history of oral drug intake was collected, and serum gastrin levels and anti-Helicobacter pylori immunoglobulin G antibody titers were measured. Upper gastrointestinal endoscopy was performed. The primary study endpoint was the association between MWFL and oral PPI intake. Results: In the univariate analyses, MWFL were observed in 35 (49.3%) of 71 patients who received oral PPIs and 10 (10.9%) of 92 patients who did not receive oral PPIs. The occurrence of MWFL was significantly higher among patients who received PPIs than in those who did not (p<0.001). Moreover, the occurrence of MWFL was significantly higher in patients with hypergastrinemia (p=0.005). In the multivariate analyses, oral PPI intake was the only significant independent factor associated with the presence of MWFL (p=0.001; odds ratio, 5.78; 95% confidence interval, 2.06-16.2). Conclusions: Our findings suggest that oral PPI intake is associated with the presence of MWFL (UMINCTR 000030144).

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참고문헌

  1. Noffsinger A. Fenoglio-Preiser's gastrointestinal pathology. 4th ed. Philadelphia: Wolters Kluwer; 2017.
  2. Kawaguchi M, Arai E, Nozawa H. An investigation of white flat elevations in the gastric body. Gastroenterol Endosc 2007;49(Suppl 1):958.
  3. Kamada T, Kawaguchi M, Maruyama Y, et al. New gastric lesion in the cardia induced by proton pump inhibitor treatment. Gastroenterology 2011;140(5 Suppl 1):S-719.
  4. Hasegawa R, Yao K, Ihara S, et al. Magnified endoscopic findings of multiple white flat lesions: a new subtype of gastric hyperplastic polyps in the stomach. Clin Endosc 2018;51:558-562.
  5. Haruma K, Shiotani A, Kamada T, et al. Problems of prolonged administration of PPI-occurrence of gastric polyps. Shokakinaika 2013;56:190-193.
  6. Yamaoka R, Yao K, Chuman K, et al. Novel endoscopic findings of multiple white flat lesions: a new subtype of hyperplastic polyps in the stomach. United European Gastroenterol J 2016;3(Suppl 1):A386.
  7. Ally MR, Veerappan GR, Maydonovitch CL, et al. Chronic proton pump inhibitor therapy associated with increased development of fundic gland polyps. Dig Dis Sci 2009;54:2617-2622.
  8. Kim GH. Proton pump inhibitor-related gastric mucosal changes. Gut Liver 2021;15:646-652.
  9. Sugawara K, Imai Y, Saito E. Cases of gastric fundic gland polyps increasing in the size during the long-term therapy with proton pump inhibitor. Gastroenterol Endosc 2009;51:1686-1691.
  10. Hongo M, Fujimoto K; Gastric Polyps Study Group. Incidence and risk factor of fundic gland polyp and hyperplastic polyp in long-term proton pump inhibitor therapy: a prospective study in Japan. J Gastroenterol 2010;45:618-624.
  11. Takeda T, Asaoka D, Tajima Y, et al. Hemorrhagic polyps formed like fundic gland polyps during long-term proton pump inhibitor administration. Clin J Gastroenterol 2017;10:478-484.
  12. Aoi K, Yasunaga Y, Matsuura N, et al. Fundic gland polyp with dysplasia developed during long-term proton pump inhibitor therapy, report of a case. Stomach Intest 2012;47:1270-1274.
  13. Yao K. The endoscopic diagnosis of early gastric cancer. Ann Gastroenterol 2013;26:11-22.
  14. Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy 1969;3:87-97.
  15. Shinozaki S, Osawa H, Miura Y, et al. The effect of proton pump inhibitors and vonoprazan on the development of 'gastric mucosal redness'. Biomed Rep 2022;16:51.
  16. Pimentel-Nunes P, Libanio D, Lage J, et al. A multicenter prospective study of the real-time use of narrow-band imaging in the diagnosis of premalignant gastric conditions and lesions. Endoscopy 2016;48:723-730.
  17. Pimentel-Nunes P, Dobru D, Libanio D, et al. White flat lesions in the gastric corpus may be intestinal metaplasia. Endoscopy 2017;49:617-618.
  18. Uedo N, Yamaoka R, Yao K. Multiple white flat lesions in the gastric corpus are not intestinal metaplasia. Endoscopy 2017;49:615-616.
  19. Kumar KR, Iqbal R, Coss E, et al. Helicobacter gastritis induces changes in the oxyntic mucosa indistinguishable from the effects of proton pump inhibitors. Hum Pathol 2013;44:2706-2710.
  20. Declich P, Ambrosiani L, Bellone S, et al. Parietal cell hyperplasia with deep cystic dilations: a lesion closely mimicking fundic gland polyps. Am J Gastroenterol 2000;95:566-568.