Endoscopic Findings,Pathological Features And Related Risk Factors Of Gastric Xanthoma

Objective Retrospectively analyzed the clinical data,endoscopic data and pathological data of GX patients,and summarized the endoscopic findings and pathological features of GX patients.To further explore the risk factors related to GX,and to provide reference for the selection of follow-up strategies and clinical treatment programs for GX patients.Methods A total of 13,937 patients who underwent electronic gastroscopy in the First People’s Hospital of Yichang from January 2019 to January 2021 were selected.According to the exclusion criteria,3487 patients were finally included in this study.Clinical,endoscopic and pathological data of the included patients were retrospectively collected.Combined with the disease examination results,235 cases of GX patients were selected as the GX group,including 184 single cases and 51 multiple cases.The remaining 3252 patients were included in the non-GX group.In order to exclude the effects of age and gender,235 patients matched with GX patients in terms of age and gender were also analyzed as the non-GX matched control group.SPSS22.0 software was used for statistical analysis,and univariate and multivariate logistic regression analysis was conducted to screen out the risk factors related to GX.Results(1)General information The average detection rate of GX in our hospital from January 2019 to January 2021 was 6.74%,which was higher than that in Europe.Among the235 GX patients,there were 140 males and 95 females,with a ratio of 1.47:1 and an average age of 57.94±11.06(27-83 years old),among which middle-aged and elderly patients over 50 years old accounted for the highest proportion.The average age of GX group was higher than that of non-GX group,GX was more common in male patients,and the difference was statistically significant(P<0.05);(2)Endoscopic performance The endoscopic manifestations of GX are typical,with a single occurrence mostly in the gastric antrum,but can also be seen in multiple parts of the stomach,with varying numbers.The maximum number of GX in the patients in this study was 8.GX under endoscopy was often associated with bile reflux,gastric polyps and atrophy,and the differences were statistically significant(P<0.05).The endoscopic score of gastric cancer risk in GX group was 3.08±1.41,which was significantly higher than that in non-GX group(P<0.05);(3)Pathological feature GX group often combined with Gastric atrophy(GA)and Intestinal Metaplasia(IM).There were statistically significant differences in atrophy degree among GX group(P<0.05),but there were no statistically significant differences in Gastric atrophy,IM and Intestinal Metaplasia degree among GX group(P<0.05).There was statistically significant difference between single GX and combined IM(P<0.05).Patients with multiple GX often had combined IM.There was statistical significance in the degree of atrophy in GX group compared with non-GX group(P<0.05),and the degree of atrophy in GX group was higher.GX group had higher Operative Link for Gastritis Assessment(OLGA)and Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)grading,with statistically significant differences(P<0.05).In addition,the advanced OLGA grade in GX group was significantly higher than that in non-GX group,with statistical significance(P<0.05);(4)Risk factor Unifactorial analysis showed that fasting blood glucose level,salted food diet,Helicobacter pylori(Hp)infection,combined GA and combined IM were related to the occurrence of GX in GX patients.Further multivariate logistic regression analysis indicated that dietary habits of preserved food(OR=0.365,95%CI:0.221-0.600),Hp infection(OR=1.908,95%CI:1.046-3.480),combined GA(OR=0.382,95%CI:0.202-0.724)and combined IM(OR=0.325,95%CI: 0.181-0.584)were significantly correlated with GX and were independent risk factors for GX;(5)Four gastric functions and Hp antibody typing Serum pepsinogen I(PGI)level in GX group was lower than that in normal control group,and the difference was statistically significant(P<0.05).There were no statistically significant differences in PGII and gastrin-17(G-17)levels between GX group and GA group and normal control group.The infection rate of Hp in GX patients was high,and the infection rate was high with type I Hp infection(toxic type).Conclusion(1)The average detection rate of GX in our center is higher than that in Europe;GX is more common in middle-aged and elderly male patients;(2)The endoscopic manifestations of GX are typical and easy to detect;GX is mostly single in the gastric antrum,but can also appear in multiple parts of the stomach,the number is different;GX patients with a higher risk of gastric cancer endoscopic presentation score;(3)GX patients often combined with GA and IM;GX patients had higher OLGA and OLGIM grades,and GX may be an endoscopic marker for early gastric cancer;(4)Pickled food diet,Hp infection,combined GA and combined IM were independent risk factors for GX.