慢性萎缩性胃炎胃镜和病理诊断的相关性探讨  

Study on the correlativity between endoscopic and pathologic diagnosis of chronic atrophic gastritis

作　　者：高建[1] 沈鼎明[1] 沈薇[1] 李孝生[1] 冷志[1] 何璐[1] 

机构地区：[1]重庆医科大学附属第二医院消化内科,400010

出　　处：《重庆医学》2005年第12期1843-1843,1846,共2页Chongqing medicine

摘　　要：目的探讨慢性萎缩性胃炎(CAG)的胃镜下表现和病理诊断的相关性.方法对57例CAG的胃镜下表现与病理诊断进行相关性分析,分别计算胃镜下各种表现对病理诊断CAG的敏感性和特异性.结果57例患者中胃镜诊断CAG 41例,CAG合并浅表性胃炎(CSG)16例;病理诊断CAG 28例,CAG合并CSG 10例,CSG 19例.CAG胃镜下诊断与病理诊断的符合率为66.67%.CAG胃镜下各种表现对病理诊断的敏感性(41.32%～65.78%)均不高.胃镜下某些表现对病理诊断CAG的特异性较高,如红白相间以白为主,血管透见对CAG病理诊断的特异性为73.67%,若胃黏膜皱襞变薄,红白相间以白为主和血管透见,黏膜粗糙不平和颗粒样改变等3种胃镜下表现并存时则对CAG病理诊断的特异性高达100%.结论慢性萎缩性胃炎胃镜和病理诊断有一定相关性,胃镜和病理检查的紧密结合有利于慢性萎缩性胃炎的正确诊断.Objective To investigate the correlativity between endoscopic manitestatations and pathologic diagnosis of chronic atrophic gastritis. Methods The correlation between gastroscopic manifestations and pathologic diagnasis of 57 patients with chronic atrophic gastritis were analyzed, and the sensitivity and specificity of CAG through various gastroscopic manifestations were calculated respectively. Results Of the 57 patients CAG 41 cases, CAG and CSG 16 cases were diagnosed by gastroscopy; the patholog ical diagnosis were CAG 28 cases, CAG and CSG 10 cases, CSG 19 cases. The coincidence rate of diagnosis between endoscopy and pathology of chronic atrophic gastritis was 66.67%. The sensitivities of various gastroscopic manifestations in CAG to their pathological diagnosis were about 41.32%- 65.78%. Some gastroscopic manifestations such as the dominated white-phase and prominent vascular pattern had high specificity to pathological diagnosis about 73.67%. The gastric mucosa thinning, dominated whitephase and prominent vascular pattern, asperous and granular changer under gastroscopy attained the specificity of 100% to pathological diagnosis. Conclusion Endoscopic diagnosis has certain correlation with pathological diagnosis in CAG. The combination of endoscopic and pathological examination is helpful to correct diagnosis of CAG.

关 键 词：慢性萎缩性胃炎 胃镜检查 病理学 相关性分析 

分 类 号：R573.3[医药卫生—消化系统]