单发胃息肉样病变内镜特点和病理特征  

Endoscopic features and pathological analysis of single gastric polypoid lesions

作　　者：马毓梅[1] 孙鹏娟[1] 王恒树[1] 崔爱荣[1] 张杰英[1] 

机构地区：[1]河北医科大学第二医院病理科,河北石家庄050000

出　　处：《临床荟萃》2015年第1期30-33,共4页Clinical Focus

基　　金：河北省科技支撑计划(09276102D-3)

摘　　要：目的观察单发胃息肉样病变的内镜和病理形态学特征,探讨不同类型胃息肉的增殖和分化特征。方法分析661例单发性胃息肉样病变临床病理特点,免疫组织化学EliVisionTMplus两步法检测63例各类型胃息肉增殖细胞核抗原(Ki67),细胞角蛋白7(CK7),细胞角蛋白20(CK20)的表达。结果内镜诊断661例单发胃息肉样病变多为炎症,只有34.9%(231/661)诊断为胃息肉;单发性胃息肉样病变主要发生于胃窦;其中增生性息肉157例,在息肉中所占比例最高,多发生在胃窦部和贲门;胃腺瘤仅7例,主要发生于胃窦;除炎性纤维性息肉外,胃息肉的腺上皮均有不同程度Ki-67表达,胃腺瘤的Ki-67标记指数明显高于其他胃息肉(P<0.05);胃息肉腺上皮免疫表型以CK7+/CK20+为主。结论胃息肉临床病理诊断符合率较低;不同类型胃息肉增殖指数不同,但免疫表型相似。ABSTRACT：Objective To observe the endoscopic and pathological features of single gastric polypoid lesion and to explore the proliferative and differentiated features of different types of gastric polyps.Methods The clinical pathological features of 661 cases with single gastric polypoid lesions were analyzed.Then,the expression of Ki-67,CK7 and CK20 of 63 cases with different types of gastric polyps were determined using EliVisionTM plus detection kit. Results Most of 661 cases diagnosed by endoscopy were inflammation by endoscpic examination.Gastric polyps only accounted for 34.9%（231/661）.Single gastric polypoid lesion mainly happened in gastric antrum.Hyperplastic polyps always found in the antrum and cardia,accounted for the highest proportion in 231 cases of gastric polyps.There were only seven cases of gastric adenomas mainly found in the antrum.Except for the inflammatory fibroid polyps,Ki-67 expression was observed in all of the other types of gastric polyps at varying degrees.The mean labeling index of Ki-67 in adenoma was significantly higher than that of the other three gastric polyps and CK7 ＋/CK20＋ was the main phenotype of gastric polyps except inflammatory fibroid polyps.Conclusion The diagnostic accordance rate of gastric polyps is relatively low in clinic.Different types of gastric polyp show different proliferation indexes but identical immune phenotypes.

关 键 词：息肉 增殖细胞核抗原 角蛋白质类 诊断 免疫组织化学 

分 类 号：R573[医药卫生—消化系统]