慢性萎缩性胃炎100例胃镜与病理诊断的对照分析  

Contrast Analysis of Gastroscopic and Pathologic Diagnosis in 100 Cases With Chronic Atrophic Gastritis

作　　者：孙良华[1] 李群[1] 孙永红[1] 曹会利[1] 黄文波[1] 

机构地区：[1]潍坊医学院附属医院消化内镜室,山东潍坊261031

出　　处：《潍坊医学院学报》2007年第3期250-252,共3页Acta Academiae Medicinae Weifang

基　　金：山东省中医药管理局计划项目(课题编号:2005-237)

摘　　要：目的 探讨胃镜下表现对慢性萎缩性胃炎(CAG)的诊断价值.方法 对胃镜诊断的100例慢性萎缩性胃炎与病理结果进行对照分析,分别计算胃镜下CAG各种表现对病理诊断CAG、肠上皮化生及异型增生的敏感性、特异性及阳性预测值.结果 100例CAG 中病理诊断84例,胃镜与病理诊断符合率为84%.胃镜下各种表现对病理诊断CAG的敏感性为21.43%～53.57%.胃镜下某些表现如黏膜粗糙不平、颗粒状或结节样改变对病理诊断肠上皮化生及异型增生的特异性最高,分别为83.33%,80.00%.胃镜下3种表现共存时对病理诊断CAG、肠上皮化生及异型增生的敏感性、特异性及阳性预测值均较高,其阳性率与单一表现比较有显著差异(P<0.01).结论 胃镜直视下的黏膜变薄、皱襞变平;血管透见、白相为主;黏膜粗糙、颗粒状或结节样改变共存时对CAG、肠上皮化生及异型增生的病理诊断价值最高,但正确的诊断还需要胃镜直视与病理诊断密切结合.Objective To investigate the diagnostic value of gastroscopic manifestatations to chronic atrophic gastritis(CAG).Methods The correlation between gastroscopic manifestations and pathologic diagnasis of 100 patients with CAG were analyzed,and the sensitivity,specificity and positive predictive value of CAG,intestinal metaplasia and dysplasia through various gastroscopic manifestations to their pathologic diagnosis were calculated respectively.Results The pathological diagnosis were CAG 84 cases,the coincidence rate of diagnosis between gastroscopy and pathology was 84%.The sensitivities of various gastroscopic manifestations in CAG to their pathological diagnosis were about 21.43%～53.57%.Some gastroscopic manifestations in intestinal metaplasia and dysplasia such as the asperous and granular changer under gastroscopy attained the highest specificities of 83.33% and 80.00% respectively to their pathological diagnosis.The sensitivity,specificity and positive predictive value of various gastroscopic manifestations coexistence in CAG,intestinal metaplasia and dysplasia attained highly to their pathological diagnosis,there was significantly difference between the positive rates of single manifestation and various manifestations(P<0.01).Conclusion The coexistence of the gastric mucosa thinning,dominated whitephase and prominent vascular pattern,asperous and granular changer under gastroscopy have the high specificity of CAG,intestinal metaplasia and dysplasia to their pathological diagnosis.The combination of gastroscopic and pathological examination is helpful to correct diagnosis of CAG.

关 键 词：胃炎 萎缩性 胃镜检查 病理学 诊断 

分 类 号：R322.4+4[医药卫生—人体解剖和组织胚胎学]