Background/Objectives: Gastric intestinal metaplasia (GIM) is considered an irreversible preneoplastic precursor for gastric adenocarcinoma in adults. However, its significance in children and the long-term outcome remain poorly understood. Methods: All children diagnosed with GIM between 2000 and 2020 were identified at a large tertiary referral centre. Upon reaching adulthood (≥18 years), the patients were invited to undergo follow-up esophagogastroduodenoscopy (using narrow-band imaging additionally to high-definition white light endoscopy), with gastric biopsies obtained according to the updated Sydney protocol. Childhood and adulthood gastric biopsies were re-evaluated by two experienced gastrointestinal pathologists using Kreyberg staining. Results: Paediatric GIM was diagnosed in 178/14,409 (1.2%) esophagogastroduodenoscopies performed during the study period. Fifty adult patients with childhood GIM agreed to participate in the study. The mean age at childhood and adulthood endoscopies were 14.3 years (median 15) and 25.2 years (median 24), respectively. The mean follow-up interval was 10.5 years. All childhood GIM cases were classified as complete-type. Notably, GIM completely resolved in 41/50 of patients (82%) by the time of adulthood follow-up. No dysplasia or carcinoma was detected in any patient. ChildhoodHelicobacter pyloriinfection, similar to other evaluated host-related factors, was not significantly associated with the persistence of GIM into adulthood (11.2% vs. 29.3%,p= 0.41). Conclusions: Childhood GIM was a rare finding but demonstrated a high rate of reversibility by adulthood regardless ofHelicobacter pyloristatus, with no cases of dysplasia or carcinoma observed during long-term follow-up.
背景/目的：胃黏膜肠上皮化生（GIM）被认为是成人胃腺癌不可逆转的癌前病变。然而，其在儿童中的意义及长期预后尚不明确。方法：在一家大型三级转诊中心，我们识别出2000年至2020年间所有诊断为GIM的儿童患者。待患者成年（≥18岁）后，邀请其接受随访性食管胃十二指肠镜检查（采用高清白光内镜联合窄带成像技术），并依据更新的悉尼方案获取胃黏膜活检标本。由两位经验丰富的胃肠道病理学家使用Kreyberg染色法，对儿童期和成年期的胃活检组织进行重新评估。结果：在研究期间进行的14,409例食管胃十二指肠镜检查中，178例（1.2%）诊断为儿童期GIM。其中50例儿童期GIM患者在成年后同意参与本研究。儿童期和成年期内镜检查的平均年龄分别为14.3岁（中位数15岁）和25.2岁（中位数24岁），平均随访间隔为10.5年。所有儿童期GIM病例均被归类为完全型。值得注意的是，至成年随访时，41/50例患者（82%）的GIM完全消退。所有患者均未检出异型增生或癌变。儿童期幽门螺杆菌感染，与其他评估的宿主相关因素类似，与GIM持续至成年期无显著关联（11.2% vs. 29.3%，p=0.41）。结论：儿童期GIM较为罕见，但无论幽门螺杆菌感染状态如何，其在成年期均表现出较高的可逆性，且在长期随访中未观察到异型增生或癌变病例。
肿瘤(癌症)患者之家