532例贲门部息肉患者的临床、内镜及病理特点分析  

Clinical,Endoscopic and Pathological Features of 532 Patients with Gastric Cardiac Polyps

作　　者：孟灵梅[1] 李渊[1] 丁士刚[1] 周丽雅[1] 金珠[1] 崔荣丽[1] 张贺军[1] 

机构地区：[1]北京大学第三医院消化内科,北京100083

出　　处：《中国微创外科杂志》2016年第3期209-212,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨胃贲门部增生性息肉的临床、内镜下表现及病理特征,提高对其认识。方法回顾性分析我院2004年1月~2015年3月532例确诊为胃贲门部增生性息肉患者临床、内镜及病理资料。结果贲门息肉最好发于齿状线处（378例,71%）,组织来源主要为胃柱状上皮（436例,82%）。仅16例（3%）息肉组织合并肠化生,8例（2%）合并低级别上皮内瘤变,1例（0.2%）合并癌变。110例（21%）合并幽门螺杆菌（H.pylori）感染。大部分（277例,52%）合并糜烂性食管炎,14例（3%）合并Barrett食管。导致食管黏膜损伤最常见病因为胃食管反流病（330例,62%）。结论胃贲门部增生性息肉是黏膜对损伤的过度再生所致,可能与胃食管反流病及H.pylori感染有关。要注重病史以及内镜检查时注意观察息肉周围病变特点。Objective To investigate the clinical,endoscopic and pathological features of cardiac hyperplastic polyps.Methods The clinical,endoscopic and pathological information of 532 patients with cardiac hyperplastic polyps from January 2004 to March 2015 were analyzed retrospectively. Results Cardiac polyps were most common in the region of the esophagogastric junction（ EGJ）（ 378 cases,71%）,and mainly composed of predominantly gastric columnar epithelium（ 436 cases,82%）. Intestinal metaplasia of the polyp was present in only 16 cases（ 3%）,low-grade dysplasia was seen in only 8 cases（ 2%）,and carcinoma with the hyperplasitc polyp was in 1 case（ 0. 2%）. A total of 110 patients（ 21%） had H. pylori infections. The majority of cases（ 277 cases,52%） were associated with concurrent erosive esophagitis. Fourteen patients（ 3%） had Barrett’s esophagus. In the most cases（ 330 cases,62%） esophageal injury was associated with gastroesophageal reflux disease（ GERD）. Conclusions Gastric cardiac hyperplastic polyp is a mucosal regenerative response to surrounding mucosal injury,which is correlated with GERD and H. pylori infections. Careful review of clinical history and observation of nonpolypoid mucosal are essential for determining the clinicopathologic context in which the polyps have developed.

关 键 词：贲门息肉 增生性息肉 糜烂性食管炎 幽门螺杆菌感染 

分 类 号：R735.2[医药卫生—肿瘤]