胃镜下胃溃疡大小与溃疡边缘组织病理改变及增殖的关系  

Relationship of diameter to pathological changes and proliferation of border tissues in gastric ulcer

作　　者：赵江蓉[1] 宋海连[1] 李华明[1] 陆磊[2] 金琳[1] 

机构地区：[1]上海市中西医结合医院消化内科,上海200082 [2]上海市中西医结合医院病理科,上海200082

出　　处：《世界肿瘤杂志》2005年第4期268-270,共3页Tumour Journal of the World

摘　　要：目的 通过对溃疡边缘组织病理变化及增殖细胞核抗原（PCNA）阳性表达与溃疡大小关系的研究，进一步探讨溃疡大小与癌变问题。方法 将胃窦、胃角溃疡按直径〈1cm，≥1cm为标准，将所收集的溃疡性病变分为A、B两组。SP免疫组织化学方法检测不同大小溃疡边缘PCNA阳性表达情况，HE染色观察病理改变和Hp检测。结果 胃溃疡边缘组织主要表现为CSG，CAG，IM，DYS，胃溃疡边缘组织PCNA阳性表达随着病变发展而升高；直径较大的溃疡PCNA表达较高，PCNA表达在直径≥1cm的溃疡高于直径〈1cm者（P〈0．05）。两组相比Hp检出率无显著差异。结论 各种因素造成的胃黏膜损伤使细胞增殖持续升高，而这些异常增殖导致胃溃疡恶变。PCNA表达与胃黏膜增殖恶化有关，且溃疡面积越大者恶变可能性越大。Objective To discuss the relationship of gastric canceration and the diameter of ulcer for pathological changes and positive expression of proliferating cell nuclear antigen （PCNA） in border tissue of gastric ulcer with different, size. Methods Ulcers generating in antrum pylori and gastric angle were divided into two groups by diameter of ulcer（Group A： 〈1cm, Group B：≥1cm）. SP immunohistochemical method was used to study the PCNA positive expression of border tissue of ulcer. Routine pathological section stained with HE was used to study the pathological changes and H.pylori infection of border tissue of ulcer. Result The border tissue of gastric ulcer mainly manifested CSC, CAC, IM, and DYS. The PCNA labeling index became higher as the histologic stage increased. PCNALI % increased as the diameter of ulcer became larger. PCNA positive expression was higher in ulcers the diameter were more than 1 cm （P〈0.05）. There was no difference between two groups in detection of H. pylori. Conclusion Various factors might cause pathological changes of gastric mucosa, that lead to the continuous increase of cell proliferation, unusual proliferation could cause malignant alteration of gastric ulcer. The possibility of malignancy increases as the diameter of ulcer becomes larger.

关 键 词：胃溃疡大小 增殖细胞核抗原 病理变化 

分 类 号：R573.1[医药卫生—消化系统]