某三级医院上消化道内镜检查1995例患者胃息肉病理特征研究  

Pathological characteristics of gastric polyps in 1995 patients undergoing upper gastrointestinal endoscopy in a tertiary hospital

作　　者：刘佳[1] Jia Liu(Department of Pathology,the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]浙江中医药大学附属第三医院病理科

出　　处：《世界华人消化杂志》2019年第16期1022-1026,共5页World Chinese Journal of Digestology

摘　　要：背景胃息肉是临床常见疾病之一,近年来随着饮食结构的改变,该病发病率逐渐呈上升趋势,通常是在行电子胃镜检查时被发现.在一定程度上具有恶变,其发生是由于某些息肉具有恶变倾向或与某些遗传疾病有关所致.因此,早期检查并活检对临床具有重要价值和意义.目的观察分析某三级医院上消化道内镜检查1995例患者胃息肉病理特征.方法对2017-09/2018-12期间在浙江中医药大学附属第三医院行上消化道内镜检查的1995例患者胃息肉发生率,息肉直径,病理类型及好发部位等进行回顾性分析.结果在1995例上消化道内镜检查中有息肉病变者390例(占19.55%),其中男性146例(37.43%),女性244例(62.56%);息肉直径3-75 mm,平均为10.2 mm±6.4 mm,其中直径≤5 mm者220例(56.41%),直径为6-10 mm者155例(39.74%),直径为11-22 mm者12例(3.08%),直径>20 mm者3例(0.77%).390例胃息肉患者中增生性息肉(hyperplastic polyp,HPs)266例(68.21%),胃底腺息肉(fundus glandular polyp,FGPs)98例(25.13%),腺瘤性息肉(adenomatous polyp,APs)26例(6.67%).HPs好发于胃角部103例(40.55%),FGPs好发于胃底部42例(42.86%),APs好发于胃角部11例(42.31%).390例胃息肉患者均行息肉切除术,其中220例息肉直径≤5 mm者采用热活检钳切除,直径>6mm 170例患者采用圈套式切除.结论本研究中,胃息肉发生率为390例(19.55%),其中HPs发生率较高68.21%,这可能与我国幽门螺旋杆菌(Helicobacter pylori,H.pylori)感染率高所导致;APs发生率较低6.67%,可能是由于H.pylori高感染率后长期使用质子泵抑制剂所致.Background Gastric polyps are a clinically common disease. In recent years, with the change of the dietary style, the incidence of gastric polyps is rising gradually. They are usually detected during electronic gastroscopy. Some polyp have a tendency of malignant transformation. Therefore, early detection and biopsy are of important value and significance clinically.AIM To analyze the pathological features of gastric polyps in 1995 patients undergoing upper gastrointestinal endoscopy in a tertiary hospital. Methods A retrospective analysis was performed on the incidence, diameter, pathological type, and location of gastric polyps in 1995 patients who underwent upper gastrointestinal endoscopy at our hospital from September 2017 to December 2018. Results Among the 1995 cases who underwent upper gastrointestinal endoscopy, 390(19.55%) had polyps, including 146(37.43%) males and 244(62.56%) females. Polyp diameter ranged from 3 to 75 mm(mean, 10.2 ± 6.4);220(56.41%) cases were ≤ 5 mm, 155(39.74%) were 6-10 mm, 12(3.08%) were 11-22 mm, and 3(0.77%) were > 20 mm. Among the 390 gastric polyps, 266(68.21%) were hyperplastic polyps(HPs), 98(25.13%) were fundus glandular polyps(FGPs), and 26(6.67%) were adenomatous polyps(APs). HPs were found in the gastric angle in 103(40.55%) cases, FGPs found in the gastric fundus in 42 cases(42.86%) cases, and APs in the gastric angle in 11(42.31%). All 390 patients with gastric polyps underwent polypectomy, among whom 220 with a polyp diameter ≤ 5 mm were excised with hot biopsy forceps, and 170 with a diameter > 6 mm were excised by snare resection. Conclusion The overall incidence of gastric polyps is 19.55% in this study cohort. The incidence of HPs is 68.21%, which may be caused by the high rate of Helicobacter pylori infection in China. The incidence of APs is 6.67%, which may be due to the long-term use of proton pump inhibitors after infection with Helicobacter pylori.

关 键 词：上消化道内镜 胃息肉 病理特征 

分 类 号：R57[医药卫生—消化系统]