| Objective: With the increase of survival rate and the more long-term postoperative complications,the precancerous lesions of gastric cancer gradually received attention in liver transplant recipients in Asia of high incidence of gastric cancer.The incidence of chronic atrophic gastritis(CAG)were discussed and the risk factors were analyzed in order to provide the theory base for measures of preventing and treating novo malignancies and improve prognosis in liver transplantation recipients.Methods: Subjects in study were patients with liver transplantation recipients in the Affiliated Hospital of Qingdao University from July 2006 to July 2019,102 patients were collected for gastroscopy.At the same time,the liver cirrhosis,hepatitis B and healthy crowd who underwent gastroscopy in the last 5 years were selected as liver cirrhosis group,hepatitis B group and physical examination group according to age and gender,and compared the incidence of CAG with liver transplantation group.Clinical data were collected such as age,gender,primary diseases and complications before liver transplantation,liver transplantation time,immunosuppressant regimen and concentration,symptoms,body mass index,smoking and drinking history,hypertension history,family history of digestive tract tumor,gastric cancer screening index,gastroscopy and pathological biopsy.Liver transplantation recipients were divided into atrophic gastritis group and non-atrophic gastritis group by atrophic gastritis or not.The related factors were analyzed by single factor,and the factors with significant difference were analyzed by multiple factors.Results: In 102 liver transplantation recipients,76 patients were male and 26 patients were female,with an average age of 56.04±9.74 years.48 patients(47.1%)of CAG were diagnosed by pathology,45 patients of atrophy with intestinal metaplasia,and 13.7% of recipients is high-risk stages of progress(OLGA III,IV).The results of gastroscopy showed that the incidence of CAG(47.1%)in liver transplantation group were higher than those in liver cirrhosis group(47.1%vs29.4%,P<0.05),hepatitis B group and physical examination group(47.1%vs37.3%,47.1%vs42.9%,P>0.05).The active infection rate of helicobacter pylori(Hp)in the liver transplantation group was 11.8%,which was significantly lower than that in the control group(P<0.05),and there was no significant difference in Hp infection for different stages of the OLGA in liver transplantation group(P<0.05).The median time from liver transplantation to CAG by gastroscopy was 33(1~170)months.The rate of follow-up time ?1 year,1 year,3 years,3~5 years,5~10 years and >10 years was 65%,38%,46%,54% and 33%(P>0.05).For univariate analysis,immunosuppressant concentration was a risk factor for CAG in liver transplantation recipients(P=0.015).The age,men,family history of digestive tract tumors,immunosuppressant concentration,Hp infection were included in Logistic regression multivariate analysis.The result showed that men(OR=3.383,95%CI 1.143~10.014),age(OR=1.057,95%CI 1.006~1.110),and immunosuppressant concentration(OR=1.4,95%CI 1.095~1.790)were independent risk factors for CAG in liver transplantation recipients.Conclusion: The incidence of CAG in liver transplantation recipients was 47.1%,which was higher than that of cirrhosis,hepatitis B and healthy physical examination population.The incidence of CAG in patients was not related to time and Hp infection after liver transplantation.Age,men,immunosuppressant concentrations were independent risk factors for CAG in liver transplantation recipients. |
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