萎缩性胃炎患者胃镜活检随访组织病理学观察  

Histopathological Observation on Atrophic Gastritis Patients by Follow-up Survey with Biopsy

作　　者：张继增[1] 赵世民[2] 

机构地区：[1]兰州军区总医院病理科,730050 [2]兰州军区总医院消化科胃镜室

出　　处：《天津医药》1995年第3期144-146,共3页Tianjin Medical Journal

摘　　要：报道50例胃镜活检随访的萎缩性胃炎,随访时间3～16年,取活检2～16次不等。首次活检萎缩性胃炎单纯型4例,肠化型46例,后者经粘液组化染色小肠化生14例,结肠化生32例。随访4～5年小肠化生和结肠化生者各检出1例不典型增生。电镜下不典型增生细胞与紧靠基底膜的储备细胞镶嵌存在,前者胞质内无肠化的粘液分泌颗粒,它和上方含粘液颗粒和微绒毛的肠化细胞无过渡形态。随访后单纯型病例增长16％(P<0.05),原肠化型(++)和(+++)分别减少6％和14％。提示肠化是萎缩性胃炎伴发的一种可逆性成熟性病变。不典型增生更多是来自未分化的多潜能储备细胞,重度增生者应活检随访,当与癌不易分辨时属于手术指征。Follow-up survey of 50 cases of atrophic gastritis with gastroscopic biopsy was reported. The follow-up survey lasted 3 to 16 years, and the number of biopsies were 2 to 16 for each case. In first biopsy, t cases had simple atrophic gastritis, and 16 cases had intestinal metaplasia; the later biopsies showed that 14 cases had enteric metaplasia and 32 cases colon metaplasia. During the follow-up survey, 2 cases of enteric or colon metaplasia developed atypical hyperplasia. Electromi-croscopically, the atypical hyperplasia cells and storage cells at basic membrane were inlaid, and there were no mucous secretion granules in the cytoplasm of atypical hyperplasia cells. After follow-up survey, cases of simple type increased 16 % (P<0. 05 ),cases of intestinal metaplasia type decreased 6%-14%: It is suggested that intestinal metaplasia in atrophic gastritis was a mature reversible lesion. Most lesions of atypical hyperplasia were from undifferential storage cells with polylatenl energy. Serious atypical hyperplasia ought to be followed with biopsy, when it can not he differentiated from gastric carcinoma, surgical operation is indicated.

关 键 词：萎缩性胃炎 肠上皮化生 活检 组织病理学 

分 类 号：R573.320.2[医药卫生—消化系统]