胃粘膜异型增生的临床病理及随访研究  

Clinicopathologic features and follow-up study on patients with gastric dysplasia

作　　者：毛增贵[1] 石海[2] 

机构地区：[1]合肥市第一人民医院蜀山分院,安徽合肥230088 [2]安徽医科大学第一附属医院消化内科,安徽合肥230022

出　　处：《安徽医药》2009年第8期927-929,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的分析胃粘膜异型增生的临床病理特征,评价不同程度异型增生患者癌变的危险性。方法对我院10年间经内镜病理诊断的1612例异型增生的临床病理资料进行回顾性分析,并总结其中74例不同程度异型增生的内镜随访结果及临床意义。结果在≥60岁患者中,中度异型增生占34.8%,明显高于轻度者(P<0.01);重度异型增生占66.6%,与轻度、中度者相比差异有显著性(P<0.01)。在≥60岁患者中,位于贲门部的异型增生占51.1%,明显高于其它部位(P<0.01)。轻度和中度异型增生随访中未发现有癌变者,而重度异型增生有9例发生癌变,癌变率为50.0%。结论60岁以上老年人面临着患胃粘膜异型增生和胃癌更大的危险,尤其在贲门部位。重度异型增生是胃癌的高度危险因素,异型增生是胃癌一个重要的癌前病变。Aim To analyse the clinicopathologic features of patients with gastric dysplasia,and to assess the risk of gastric carcinoma in patients with histologically verified dysplasia of the stomach.Methods Retrospective analysis of clinicopathologic findings of 1612 patients with gastric dysplasia was performed.74 patients with mild（n=23）,moderate（n=33）,and severe（n=18） dysplasia among 1612 cases were followed up with repeated gastroscopies.Results The proportion of patients who were above 60 years of age was signifi1612 cases were followed up with repeated gastroscopies. Results The proportion of patients who were above 60 years of age was signifi- cantly greater in moderate dysplasia compared with that in mild dysplasia （34.8% vs. 25.7%, P 〈 0.01 ）. The percentage of patients who were above 60 years of age in severe dysplasia was much higher than that in mild and moderate dysplasia （P 〈 0.01 ）. The proportion of patients who were above 60 years of age was significantly higher in the gastric cardia than that in the gastric antrum, corpus, or angularis （P 〈 0.01 ）. No gastric carcinomas were observed in the groups of mild and moderate dysplasia during follow up. Nine out of our eighteen severe dysplasia patients developed gastric cancer （50.0%）. Conclusions Age above 60 years is a high risk factor for suffering gastric dysplasia and carcinoma, especially in the gastric cardia. Severe dysplasia seems to be highly predictive of gastric malig- nancy and immediate surgery is indicated. Gastric dysplasia should be regarded as an important precancerous lesion.

关 键 词：异型增生 胃癌 临床病理特征 随访研究 

分 类 号：R735.2[医药卫生—肿瘤]