Factors affecting occurrence of gastric varioliform lesions: A case-control study.
OBJECTIVE
To investigate the factors influencing the occurrence of gastric varioliform lesions (GVLs) and their possible link with gastric cancer.


METHODS
A 1:1 matched case-control study was performed to retrospectively analyze data from 1638 chronic gastritis patients who had undergone gastroscopy at one of two Chinese hospitals between 2009 and 2014. Patients with GVLs (cases) were compared to those without such lesions (controls). Endoscopic and pathological findings were recorded, along with interview information on Helicobacter pylori (H. pylori) infection, medical, drug and family histories, lifestyle and eating habits. The association between each factor and the occurrence of GVLs was estimated, and then multivariate conditional logistic regression was used to evaluate the independent factors.


RESULTS
The frequency and severity of glandular atrophy, intestinal metaplasia (IM) and low-grade intraepithelial neoplasia were significantly increased in the GVL group (P < 0.01). Overall analysis showed that H. pylori infection [3.051 (2.157, 4.317), P <0.001], allergic respiratory diseases [3.636 (2.183, 6.055), P < 0.001], work-related stress [2.019 (1.568, 2.600), P < 0.001], irregular meals [2.300 (1.462, 3.619), P < 0.001], high intake of spicy food [1.754 (1.227, 2.507), P = 0.002] and high intake of fresh fruit [0.231 (0.101, 0.529), P = 0.001] were significantly correlated with the occurrence of GVLs (positively, except for the latter). Stratified analyses indicated that pickled food consumption in patients over 50 years old [7.224 (2.360, 22.115), P = 0.001] and excessive smoking in men [2.013 (1.282, 3.163), P = 0.002] were also positively correlated, and that, for antral GVLs, vegetable consumption [0.491 (0.311, 0.776), P = 0.002] was negatively correlated.


CONCLUSIONS
Seven risk factors and two protective factors are determined for GVLs, which were found to be associated with premalignant abnormalities.
Tian-Hui Zou, Qin-Yan Gao, Xuan Kong, Xiao-Yu Chen, Zhi-Zheng Ge, Ying-Xuan Chen, Jing-Yuan Fang, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
Tian-Hui
TH
Zou
Tian-Hui Zou, Qin-Yan Gao, Xuan Kong, Xiao-Yu Chen, Zhi-Zheng Ge, Ying-Xuan Chen, Jing-Yuan Fang, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
Ru-Hua
RH
Zheng
Tian-Hui Zou, Qin-Yan Gao, Xuan Kong, Xiao-Yu Chen, Zhi-Zheng Ge, Ying-Xuan Chen, Jing-Yuan Fang, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
Qin-Yan
QY
Gao
Tian-Hui Zou, Qin-Yan Gao, Xuan Kong, Xiao-Yu Chen, Zhi-Zheng Ge, Ying-Xuan Chen, Jing-Yuan Fang, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
Xuan
X
Kong
Tian-Hui Zou, Qin-Yan Gao, Xuan Kong, Xiao-Yu Chen, Zhi-Zheng Ge, Ying-Xuan Chen, Jing-Yuan Fang, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
Xiao-Yu
XY
Chen
Tian-Hui Zou, Qin-Yan Gao, Xuan Kong, Xiao-Yu Chen, Zhi-Zheng Ge, Ying-Xuan Chen, Jing-Yuan Fang, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
Zhi-Zheng
ZZ
Ge
Tian-Hui Zou, Qin-Yan Gao, Xuan Kong, Xiao-Yu Chen, Zhi-Zheng Ge, Ying-Xuan Chen, Jing-Yuan Fang, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
Ying-Xuan
YX
Chen
Tian-Hui Zou, Qin-Yan Gao, Xuan Kong, Xiao-Yu Chen, Zhi-Zheng Ge, Ying-Xuan Chen, Jing-Yuan Fang, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
Xiao-Ping
XP
Zou
Tian-Hui Zou, Qin-Yan Gao, Xuan Kong, Xiao-Yu Chen, Zhi-Zheng Ge, Ying-Xuan Chen, Jing-Yuan Fang, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
Jing-Yuan
JY
Fang
D001284:Atrophy; D002278:Carcinoma in Situ / Q000209:etiology* / Q000473:pathology; D016009:Chi-Square Distribution; D002681:China; D002908:Chronic Disease; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005756:Gastritis / Q000209:etiology* / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011230:Precancerous Conditions / Q000209:etiology* / Q000473:pathology; D065840:Protective Factors; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013274:Stomach Neoplasms / Q000209:etiology* / Q000473:pathology
Gastric cancer; Gastric varioliform lesions; Precancerous lesion; Risk factor; Varioliform gastritis