The Relationship between Gastric Cancer and its Precancerous Lesions and Bile Reflux: A Retrospective Study.

AIM: To evaluate the relationship between gastric cancer and its precancerous lesions and bile reflux. METHODS: We reviewed 30 465 cases that experienced common gastroscopy between January and December 2018. Our research documented the ID number, sex, age, time of endoscopy, diagnosis and bile reflux grade of the patients. After diagnosis, patients were divided into the chronic gastritis group (n = 27 807), precancerous lesion group (n = 1943), or gastric cancer group (n = 715). The degree of bile reflux under gastroscopy was classified as grade 0, I, II, or III. We performed chi-squared and hierarchical analyses on the data. RESULTS: Patients aged 18-27 years had a higher bile reflux detection rate than those 28-37 and 68-75 years old (P = 0.000). No noticeable difference in the bile reflux detection rate was found based on median age (P = 0.639), but it was noticeably lower in men than in women (P < 0.001). The detection rate was not significantly different, which was based on months, seasons, and years (P = 0.240, P = 0.213, P = 0.157), but there was a noticeable difference between morning and afternoon rates (P = 0.000). There was an interrelationship between the severity of gastric mucosal disease and the bile reflux grade (rs = 0.171). After excluding the effects of sex, age and time on bile reflux, the bile reflux detection rate in chronic gastritis and precancerous lesions were evidently lower than in gastric cancer (P = 0.000). CONCLUSIONS: Bile reflux may be a risk factor of gastric cancer and precancerous lesions. A higher degree of bile reflux may be associated with the progression of gastric mucosal disease. This article is protected by copyright. All rights reserved.