胃窦黏膜肠上皮化生类型与程度的关系及其临床意义  

Correlation between type and degree of intestinal metaplasia in antrum of stomach and its clinical significance

作　　者：刘杰英[1] 韩艳春[1] 杨东霞[1] 刘鲁英[1] 

机构地区：[1]滨州医学院病理学教研室,滨州256603

出　　处：《临床与实验病理学杂志》2011年第2期134-137,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨胃窦黏膜肠上皮化生类型与程度的关系及其临床意义,揭示胃黏膜肠化的特性及其发生机制。方法通过光镜观察和免疫组化染色检测99例胃窦黏膜肠化的类型、程度、肠化腺体周围pericryptal fibroblast sheath(PCFs)、同源异形盒基因CDX2蛋白的表达及其之间的相互关系。结果不同程度胃窦黏膜肠化病变其肠化类型存在显著性差异,轻度肠化病变中Ⅰ型肠化所占的比例显著高于中、重度肠化(P<0.001),肠化的类型与程度密切相关(r=0.540,P<0.001)。肠化腺体周围是否存在PCFs与CDX2蛋白表达显著正相关(r=0.584,P<0.001)。结论肠化的程度间接反映了肠化的类型。在临床工作中,通过对肠化的程度进行分级,粗略判断肠化的类型及其是否需要密切随访是可行的。Purpose To explore the clinical significance of detecting the type and degree of intestinal metaplasia and the molecular pathogenesis of intestinal metaplasia in antrum of stomach.Methods Light microscopy and immunohistochemical staining were used in this study.Types and degree of intestinal metaplasia,pericryptal fibroblast sheath（PCFs）and CDX2 expression were observed in 99 cases of gastric biopsies.Results The type of intestinal metaplasia was significantly different among groups with various degree of intestinal metaplasia.Slight intestinal metaplasia presented in more cases with type I intestinal metaplasia than types Ⅱ and Ⅲ.And there were more cases with type Ⅲ in severe intestinal metaplasia（P0.001）.In 99 cases of gastric mucosa samples of intestinal metaplasia,PCFs were recognized in 63 cases（63.6%）.The development of PCFs was significantly correlated with the expression of CDX2（r=0.584,P0.001）.Conclusions The degree of intestinal metaplasia can properly reflect the type of intestinal metaplasia.It is very convenient to observe the degree of intestinal metaplasia with light microscope by pathologists.It may be accepted and widely used by clinicians to estimate the type of intestinal metaplasia and to decide if the patients need to be followed up according to the degree of intestinal metaplasia.

关 键 词：胃黏膜 肠上皮化生 同源异形盒基因CDX2 pericryptal FIBROBLAST SHEATH 

分 类 号：R573[医药卫生—消化系统]