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Open Access Research article

Chronic gastritis in China: a national multi-center survey

Yiqi Du1, Yu Bai1, Pei Xie1, Jingyuan Fang2, Xiaozhong Wang3, Xiaohua Hou4, Dean Tian5, Chengdang Wang6, Yandi Liu7, Weihong Sha8, Bangmao Wang9, Yanqing Li10, Guoliang Zhang11, Yan Li12, Ruihua Shi13, Jianming Xu14, Youming Li15, Minghe Huang16, Shengxi Han17, Jie Liu18, Xu Ren19, Pengyan Xie20, Zhangliu Wang21, Lihong Cui22, Jianqiu Sheng23, Hesheng Luo24, Zhaohui Wang25, Xiaoyan Zhao26, Ning Dai27, Yuqiang Nie28, Yiyou Zou29, Bing Xia30, Zhining Fan31, Zhitan Chen32, Sanren Lin33, Zhao-Shen Li1* and on behalf of Chinese Chronic Gastritis Research group

Author Affiliations

1 Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China

2 Department of Gastroenterology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

3 Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou, China

4 Department of Gastroenterology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China

5 Department of Gastroenterology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China

6 Department of Gastroenterology, First Hospital of Fujian Medical University, Fuzhou, China

7 Department of Gastroenterology, People’s Hospital of Tianjin, Tianjin, China

8 Department of Gastroenterology, Guangdong Provincial People’s Hospital, Guangzhou, China

9 Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin, China

10 Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China

11 Department of Gastroenterology, First Central Hospital of Tianjin, Tianjin, China

12 Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China

13 Department of Gastroenterology, Jiangsu Provincial People’s Hospital, Nanjing, China

14 Department of Gastroenterology, First Hospital of Anhui Medical University, Hefei, China

15 Department of Gastroenterology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China

16 Department of Gastroenterology, Shenzhen TCM Hospital, Shenzhen, China

17 Department of Gastroenterology, Sichuan Provincial People’s Hospital, Chengdu, China

18 Department of Gastroenterology, Huashan Hospital, Fudan University, Shanghai, China

19 Department of Gastroenterology, Heilongjiang Provincial Hospital, Harbin, China

20 Department of Gastroenterology, Peking University First Hospital, Beijing, China

21 Department of Gastroenterology, Zhejiang Provincial Xinhua Hospital, Hangzhou, China

22 Department of Gastroenterology, Navy General Hospital of PLA, Beijing, China

23 Department of Gastroenterology, General Hospital of Beijing Military Region of PLA, Beijing, China

24 Department of Gastroenterology, Hubei Provincial People’s Hospital, Wuhan, China

25 Department of Gastroenterology, Dalian Central Hospital, Dalian, China

26 Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China

27 Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China

28 Department of Gastroenterology, Guangzhou First Municipal People’s Hospital, Affiliated Guangzhou Medical College, Guangzhou, China

29 Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha, China

30 Department of Gastroenterology, Central South Hospital, Wuhan University, Wuhan, China

31 Department of Gastroenterology, Second Affiliated Hospital, Nanjing Medical University, Nanjing, China

32 Department of Gastroenterology, Nanjing BenQ Medical Center, Nanjing, China

33 Department of Gastroenterology, Peking University Third Hospital, Beijing, China

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BMC Gastroenterology 2014, 14:21  doi:10.1186/1471-230X-14-21

Published: 7 February 2014

Abstract

Background

Chronic gastritis is one of the most common findings at upper endoscopy in the general population, and chronic atrophic gastritis is epidemiologically associated with the occurrence of gastric cancer. However, the current status of diagnosis and treatment of chronic gastritis in China is unclear.

Methods

A multi-center national study was performed; all patients who underwent diagnostic upper endoscopy for evaluation of gastrointestinal symptoms from 33 centers were enrolled. Data including sex, age, symptoms and endoscopic findings were prospectively recorded.

Results

Totally 8892 patients were included. At endoscopy, 4389, 3760 and 1573 patients were diagnosed to have superficial gastritis, erosive gastritis, and atrophic gastritis, respectively. After pathologic examination, it is found that atrophic gastritis, intestinal metaplasia and dysplasia were prevalent, which accounted for 25.8%, 23.6% and 7.3% of this patient population. Endoscopic features were useful for predicting pathologic atrophy (PLR = 4.78), but it was not useful for predicting erosive gastritis. Mucosal-protective agents and PPI were most commonly used medications for chronic gastritis.

Conclusions

The present study suggests non-atrophic gastritis is the most common endoscopic finding in Chinese patients with upper GI symptoms. Precancerous lesions, including atrophy, intestinal metaplasia and dysplasia are prevalent in Chinese patients with chronic gastritis, and endoscopic features are useful for predicting pathologic atrophy.

Keywords:
Chronic gastritis; Endoscopy; Epidemiology