胃黏膜活检低级别上皮内瘤变的转归及其与早期胃癌的关系  

Biopsy-diagnosed low-grade intraepithelial neoplasia in relation to early gastric cancer

作　　者：胡柯峰[1] 叶国良[1] 郑拓[1] 张新军[1] 王伯军[1] 盛红 

机构地区：[1]宁波大学医学院附属医院消化内科,315000 [2]象山县第一人民医院消化内科

出　　处：《浙江医学》2014年第2期134-136,143,共4页Zhejiang Medical Journal

基　　金：宁波市医学科技计划项目(2010A07)

摘　　要：目的比较胃黏膜活检提示低级别上皮内瘤变(LGIN)患者的临床、胃镜特点与胃镜黏膜下剥离术后病理之间的关系。方法对胃镜下胃黏膜活检提示LGIN的124例患者实施胃镜黏膜下剥离术,分析患者的临床、胃镜特点和病理资料,并与术后病理诊断结果进行对比。结果术后75例(60.5%)维持LGIN诊断,23例(18 5%)提示黏膜慢性炎症和(或)伴萎缩、肠上皮化生,12例存在(9.7%)高级别上皮内瘤变,14例(11.3%)早期胃癌。研究发现,术后病理结果与患者性别、病变位置、胃镜下形态无关(均P>0.05),而与年龄及病变长径有关(均P<0.05)。结论胃镜下胃黏膜活检为LGIN的患者存在癌变的风险,应对其实施密切随访或胃镜下治疗,应十分谨慎。Objective To compare the clinical and pathological features of biopsy- diagnosed low grade intraepithelial neoplasia（LGIN） of gastric mucosa with the pathological findings of endoscopic submucosal dissection. Methods Endoscopic submucosal dissection was performed on124 patients with biopsy- confirmed LGIN of gastric mucosa. The relationship between clinicopathological features of LGIN and pathological findings of submucosal dissection was investigated. Results The histopathology on 124 cases of endoscopic submucosal dissection confirmed 75 cases （60.5%） of LGIN, 12 cases （9.7%） of HGIN, 23 cases （18.5%） of chronic gastritis with or without atrophy and intestinal metaplasia, and 14 cases （11.3% ） of early gastric cancer. The pathological diagnoses of submucosal dissection specimens were significant correlated with the age of pa-tients and the size of lesions（P〈0.05）, but not correlated with the gender of patients, the appearance and location of lesions on biopsydiagnosed LGIN（〉0.05）. Conclusion Patients with biopsydiagnosed LGIN of stomach mucosa may have a possi-bility of early gastric cancer, thus positive fol owup and the minimal endoscopic resection for low category dysplasia is recom-mended.

关 键 词：胃肿瘤 活组织检查 上皮内瘤变 胃镜黏膜下剥离术 诊断 

分 类 号：R735.2[医药卫生—肿瘤]