Supplementary Material for: Factors Associated with Gastric Black Spot, White Flat Elevated Mucosa, and Cobblestone-Like Mucosa: A Cross-Sectional Study

<b><i>Background/Aims:</i></b> Previous studies have reported a possible relevance between proton pump inhibitor (PPI) use and 3 new gastric mucosal changes: black spots (BSs), white flat elevated mucosa (WFEM), and cobblestone-like mucosa (CLM). The aim of this study was to investigate the association between these mucosal changes and multiple factors including PPI use. <b><i>Methods:</i></b> All subjects who underwent a routine esophagogastroduodenoscopy (EGD) were successively enrolled. Endoscopists carried out the EGD after being blinded about ­information on patient PPI usage and determined the presence of these mucosal changes. The ratio of each factor was ­compared in cases with and without each gastric finding. <b><i>Results:</i></b> Out of 1,214 patients, BSs were recognized in 75 (6.2%) cases, WFEM in 59 (4.9%), and CLM in 41 (3.4%). In logistic regression analysis, PPI use was significantly correlated with all of these findings (BSs: OR 2.94; 95% CI 1.66–5.21), (WFEM: OR 3.58; 95% CI 1.94–6.61), and (CLM: OR 4.57; 95% CI 2.34–9.96), and <i>Helicobacter pylori</i> eradication was related to BSs (OR 3.01; 95% CI 1.73–5.24) and WFEM (OR 2.11; 95% CI 1.08–4.11). Decision-tree analyses showed that <i>H. pylori</i> eradication was associated with all findings. <b><i>Conclusions:</i></b> All of the considered findings were correlated with PPI and <i>H. pylori</i> eradication.

<b><i>研究背景与目的：</i></b> 既往研究已报道质子泵抑制剂（proton pump inhibitor, PPI）的使用与三种新型胃黏膜病变存在潜在关联：黑斑（black spots, BSs）、白色扁平隆起性黏膜（white flat elevated mucosa, WFEM）以及鹅卵石样黏膜（cobblestone-like mucosa, CLM）。本研究旨在探讨上述胃黏膜病变与包括PPI使用在内的多种相关因素之间的关联。
<b><i>研究方法：</i></b> 本研究连续纳入所有接受常规食管胃十二指肠镜检查（esophagogastroduodenoscopy, EGD）的受试者。内镜医师在不知晓受试者PPI使用信息的前提下实施该检查，并判定上述胃黏膜病变是否存在。分别比较存在与不存在各胃黏膜病变的受试者中各相关因素的占比。
<b><i>研究结果：</i></b> 共计纳入1214例患者，其中75例（6.2%）检出黑斑，59例（4.9%）检出白色扁平隆起性黏膜，41例（3.4%）检出鹅卵石样黏膜。Logistic回归分析显示，PPI使用与上述所有病变均存在显著相关性（黑斑：优势比（odds ratio, OR）2.94；95%置信区间（confidence interval, CI）1.66–5.21；白色扁平隆起性黏膜：OR 3.58；95%CI 1.94–6.61；鹅卵石样黏膜：OR 4.57；95%CI 2.34–9.96）；幽门螺杆菌（Helicobacter pylori）根除治疗与黑斑（OR 3.01；95%CI 1.73–5.24）及白色扁平隆起性黏膜（OR 2.11；95%CI 1.08–4.11）相关。决策树分析结果显示，幽门螺杆菌根除治疗与所有上述病变均存在关联。
<b><i>研究结论：</i></b> 本研究纳入的所有上述胃黏膜病变均与PPI使用及幽门螺杆菌根除治疗存在相关性。