위암 발생의 위험요인이 위상피 이형성 발생에 미치는 영향 = Influence of Stomach Cancer Risk Factors on the Development of Gastric Dysplasia

국문 초록 (Abstract)

연구배경: 위축성 위염 및 장상피 화생은 흔하게 접할 수 있는 질환으로 위상피 이형성을 거쳐 위암으로 발전될 가능성이 있는 것으로 알려져 있다.
방법: 2004년 1월부터 2008년 12월까지 위내시경 검사로 위축성 위염 및 장상피 화생이 진단된 후 내시경 검사를 받은 1438명을 대상으로 연령, 성별, 흡연량, 음주력, 곡류 섭취량, 위암 가족력에 따른 위상피 이형성 누적발생률을 조사하였다.
결과: 연령이 증가할수록(P<0.001), 하루 3공기 이상의 곡류 섭취(P=0.008), 위암의 가족력이 있는 군(P=0.008)에서 이형성 발생률이 높았고, 위상피 이형성 발생률을 예측하는 지표는 61세 이상 연령(RR=2.54, P=0.014), 하루 3공기 이상의 곡류 섭취량 RR=1.46, P=0.021), 위암의 가족력(RR=1.31, P=0.037)이었다.
결론: 위축성위염 및 장상피화생이 있는 경우에 61세 이상, 하루 세 공기 이상의 곡류 섭취, 위암의 가족력이 있는 환자에서 위상피 이형성 발생률이 증가하였다. 따라서 이러한 위험요인이 있는 경우 위암 전구 단계인 이형성 발생률이 증가한다는 것에 대한 교육과 함께 금연 등의 생활습관 교정이 필요하겠다.

다국어 초록 (Multilingual Abstract)

Background: Both atrophic gastritis and intestinal metaplasia may progress to gastric dysplasia. This study aimed to analyze the factors influencing progression of atrophic gastritis and intestinal metaplasia to dysplasia.
Methods: People diagnosed with atrophic gastritis and intestinal metaplasia for the first time received a follow-up endoscopy and were investigated for the cumulative incidence rate of gastric dysplasia by age, gender, smoking habit, alcohol intake, rice consumption and family history of stomach cancer.
Results: The cumulative incidence rate increased with age, consuming ≥3 bowls of rice per day and family history of stomach cancer. Multivariate analysis showed that the cumulative incidence rate of gastric dysplasia increased in subjects >61 years (RR=2.54, P=0.014), in those consuming ≥3 bowls of rice per day (RR=1.46, P=0.021) and in those with a family history of stomach cancer (RR=1.31, P=0.037).
Conclusions: More active management, such as intensive endoscopic follow-up examinations, lifestyle change and education regarding gastric dysplasia, are required in those older than 61 years, having a higher intake of grain or with a family history of stomach cancer.

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