胃黄色瘤的临床病理特征  

CLINICOPATHOLOGICAL FEATURES OF GASTRIC XANTHELASMA

作　　者：王世杰[1] 毛涛[1] 田字彬[1] WANG Shijie;MAO Tao;TIAN Zibin(Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Chin)

机构地区：[1]青岛大学附属医院消化内科,山东青岛266003

出　　处：《青岛大学学报（医学版）》2018年第2期229-232,共4页Journal of Qingdao University(Medical Sciences)

摘　　要：目的研究胃黄色瘤的临床病理特征及其与胃黏膜病变的关系。方法选取2016年3—9月在青岛大学附属医院接受内镜检查、排除严重心肝肾疾病、长期使用非甾体抗炎药、胃切除术以及内镜下黏膜剥离术(ESD)术后的病人,共有8 410例入选。回顾性分析有黄色瘤组及未检出黄色瘤组(非黄色瘤组)病人的性别、年龄、胃萎缩的严重程度、胃黄色瘤的存在情况(数目、大小、位置)、胃癌的存在情况以及临床病理特征(例如幽门螺杆菌(HP)感染、肠上皮化生、萎缩及不典型增生等),并探讨胃黄色瘤与上述因素之间尤其是与胃癌之间的关系。结果 8 410例病人检测出胃黄色瘤187例(2.2%),病变可发生在全胃,以胃窦(51.3%)最为多见;可单发或多发,以单发(63.1%)更常见。胃黄色瘤与病人年龄、性别无关(P>0.05);胃黄色瘤组中开放型萎缩性胃炎、肠上皮化生、不典型增生、HP感染及胃癌的检出率均高于非黄色瘤组,差异有显著性(χ2=3.20~80.60,P<0.05)。胃癌组胃黄色瘤的检出率显著高于非胃癌组(χ2=12.61,P<0.05)。结论开放型萎缩性胃炎、肠上皮化生、不典型增生、HP感染、胃癌可能是胃黄色瘤发生的危险因素;胃黄色瘤与胃癌存在相关性,可作为胃癌的一个预警信号。Objective To study the clinicopathological features of gastric xanthelasma and its relationship with gastric mucosal lesion. Methods A total of 8 410 patients who underwent endoscopic examinations in our hospital from March to September,2016 were enrolled as subjects.None of the patients had severe heart and kidney diseases,long-term use of non-steroidal anti-inflammatory drugs,gastric resection,or endoscopic submucosal dissection.Retrospective studies were performed on the sex,age,severity of gastric atrophy,features of gastric xanthelasma（number,size,and location）,incidence of gastric cancer,and various clinicopathological features（Helicobacter pylori infection,intestinal metaplasia,atrophy,and atypical hyperplasia）among patients diagnosed with and without gastric xanthelasma.The relationship of gastric xanthelasma with the above factors,particularly with gastric cancer,was evaluated. Results In the 8 410 patients,187（2.2%）were diagnosed with gastric xanthelasma.Lesions could occur all over the stomach and were mostly observed in the gastric antrum（51.3%）.The incidence of single lesion（63.1%）was higher than that of multiple lesions.Gastric xanthelasma had no significant relationship with age or sex（P〈0.05）.The detection rates of atrophic gastritis,intestinal metaplasia,atypical hyperplasia,Helicobacter pylori infection,and gastric cancer were significantly higher in patients with gastric xanthelasma than in those without gastric xanthelasma（χ^2=3.20-80.60,P〈0.05）.The detection rate of gastric xanthelasma was significantly higher in patients with gastric cancer than in those without gastric cancer（χ^2=12.61,P〈0.05）. Conclusion Atrophic gastritis,intestinal metaplasia,atypical hyperplasia,Helicobacter pylori infection,and gastric cancer may be the risk factors for gastric xanthelasma.Gastric xanthelasma is associated with gastric cancer,which can be used as a warning sign for gastric cancer.

关 键 词：胃黄色瘤 胃肿瘤 胃炎 萎缩性 病理学 临床 

分 类 号：R573.9[医药卫生—消化系统]