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Objective To analyze the epidemiological characteristics and risk factors of gastric cancer after eradication of ( Helicobacter pylori , Hp) in Fuzhou area, to provide a theoretical basis for reducing the incidence and mortality of gastric cancer after eradication of Hp, and to provide effective suggestions for the prevention of gastric cancer in residents in Fuzhou. Methods A total of 699 patients with Hp eradication admitted to our hospital from January 2020 to December 2020 were selected. According to whether the patients had gastric cancer after eradication, they were divided into control group (no gastric cancer) and observation group (gastric cancer). The serum levels of tumor markers including CEA, CA125 and CA199 were detected and compared between the two groups. Clinical data of the two groups, including age, sex, family history of gastric cancer, course of Hp infection, open atrophy, severe atrophy of gastric mucosa, presence of intestinal metaplasia (IM) of gastric mucosa, xanxoma of gastric mucosa, and long-term use of proton pump inhibitors (PPIs), were analyzed using the self-made survey scale in our hospital. Univariate analysis and logistic regression were used to analyze the risk factors for gastric cancer after Hp eradication. Results Among of 699 patients with Hp eradication, 48 cases (6.96%) developed gastric cancer, including 29 male cases and 19 female cases. The incidence rate of males was significantly higher than that of females (P3 years between the two groups (P3 years (OR=3.631) were independent risk factors for gastric cancer after Hp eradication (P<0.05). Conclusion There is a high risk of gastric cancer after HP eradication in Fuzhou, mainly in elderly male patients, especially in patients with IM, severe atrophy of gastric mucosa and long-term use of PPIs, often accompanied by elevated levels of tumor markers. Close gastroscopy follow-up examination must be conducted within 4 to 5 years after Hp eradication, which is helpful for screening high-risk groups of gastric cancer, preventing gastric cancer and treating gastric cancer as early as possible after Hp eradication.
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Background:Epidemiological studies suggest considerable overlap between functional dyspepsia (FD) and irritable bowel syndrome (IBS).Increased duodenal eosinophil counts have been observed in patients with FD,and the density of chromogranin A (CgA)-positive cells was reduced in duodenum in patients with IBS.Aims:To investigate the alterations and significance of duodenal eosinophils and CgA-positive cells in patients with FD and FD-diarrhea-predominant IBS (IBS-D) overlap.Methods:Outpatients with FD and FD-IBS-D overlap who fulfilled Rome Ⅲ criteria from Aug.2014 to Mar.2015 at the First Affiliated Hospital of Fujian Medical University were enrolled.Biopsy specimens were collected from the duodenal bulb for HE staining and CgA immunohistochemical staining.Eosinophils and CgA-positive cells were counted,and their associations with clinical symptoms were analyzed.Results:Twenty-eight FD patients and twelve FD-IBS-D overlap patients were enrolled in this study.Duodenal bulb eosinophil counts were significantly higher in FD-IBS-D overlap patients than in FD patients [(43.83 ± 7.34)/5HPF vs.(22.90 ± 8.93)/5HPF,P ＜ 0.05],while the density of duodenal bulb CgA-positive cells were significantly lower in FD-IBS-D overlap patients than in FD patients [(13.03 ±5.87)/HPF vs.(19.85 ± 9.18)/HPF,P ＜ 0.05].Spearman correlation coefficient analysis revealed that duodenal eosinophil counts were positively correlated with lower gastrointestinal symptoms such as abdominal pain/discomfort and diarrhea,whereas no correlations were found between density of duodenal CgA-positive cells and both upper and lower gastrointestinal symptoms.Conclusions:Duodenal bulb eosinophil counts are increased and CgA-positive cells are reduced in FD-IBS-D overlap patients than in non-overlap FD patients,which may implicate the difference in clinical symptoms between these two functional gastrointestinal disorders.