慢性胃炎内镜表现与胃癌前病变检出能力分析  

Relationship between endoscopic features and the histologic diagnosis of chronic gastritis

作　　者：李楠[1] 张磊[1] 胡咏梅[2,3] 罗玲玲[1] 许建明[1,3] 

机构地区：[1]安徽医科大学第一附属医院消化内科,合肥230022 [2]安徽医科大学第一附属医院科研处,合肥230022 [3]安徽省消化系病重点实验室,合肥230022

出　　处：《安徽医科大学学报》2016年第3期403-405,共3页Acta Universitatis Medicinalis Anhui

基　　金：国家自然基金青年基金资助项目(编号:81100269)

摘　　要：目的探讨慢性胃炎内镜表现与病理诊断胃癌前病变的相关性。方法收集574例接受内镜检查的慢性胃炎患者,比较内镜表现(红斑、出血、糜烂、白相为主)与病理结果,分析其诊断的灵敏度和特异度。结果内镜表现红斑、出血、糜烂、白相为主均不同程度检出黏膜萎缩、肠上皮化生和上皮内瘤变,其中白相为主诊断中—重度黏膜萎缩、肠上皮化生和低级别上皮内瘤变特异度最高,且其联合糜烂或出血内镜表现后诊断灵敏度提高。结论当慢性胃炎内镜下表现为白相为主、尤其是合并出血或糜烂时,予以病理活组织检查,有助于胃癌前病变的检出。Objective To investigate the correlation between endoscopic features and the histologic diagnosis of chronic gastritis. Methods 574 adult individuals who underwent endoscopy were enrolled in this study. And com- pared the endoscpic festures, including erythema, erosions, hematin, and the dominated white phase with histolog- ic diagnosis. Results Mucosal atrophy, intestinal metaplasia and low grade intraepithelial neoplasia were found in the four kinds of endoscpic festures. The highest specificity for premalignant gastric lesions was the dominated white phase. However some patients with pathologic premalignant gastric lesions did not have typical endoscopic appear- ance. Combining the dominated white phase with other endoscpic festures could increase accuracy for the diagnosis of premalignant gastric lesions. Conclusion Patients with white phase dominated endoscpic, particularly accompa- nied with hematin and erosions, need further histological examination. These endoscopic features conduce to the di- agnosis of premalignant gastric lesions.

关 键 词：内镜 螺杆菌 病理 胃炎 

分 类 号：R573.3[医药卫生—消化系统]