胃黏膜低级别上皮内瘤变的临床病理特征及随访研究  

Clinical pathologic features of gastric low-grade intraepithelial neoplasia and follow-up study

作　　者：常青[1] 吴道宏[1] 宫媛[1] 赵云霞[1] 王刚石[1] 万军[1] 徐世平[1] Chang Qing;Wu Daohong;Zhao Yunxia(Digestive department of the Second medical center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心消化内科国家老年疾病临床医学研究中心,北京100853

出　　处：《中华保健医学杂志》2020年第6期624-626,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨胃黏膜低级别上皮内瘤变(LGIN)的临床病理特征及预后。方法回顾性分析2012年5月~2017年5月解放军总医院第二医学中心53503例胃镜检查结果,发现胃黏膜LGIN患者509例,其中260例进行了平均32个月随访。结果胃黏膜LGIN总检出率0.95%,其中轻度异型增生0.87%,中度异型增生0.08%;60岁以上老年患者患病率最高,为1.5%;胃窦部多见,占74.1%;伴有慢性炎症者为84.5%,伴有急性炎症者为42.6%;伴有萎缩者为15.3%,伴有肠化者为67.0%,且萎缩、肠化与年龄、部位、镜下形态有关(P<0.05)。随访患者轻度异型增生消失率88.8%,癌变率0.4%,并发其他部位恶性肿瘤发生率为0.8%;中度异型增生消失率68.4%,癌变率10.5%。结论胃黏膜LGIN患病率随着年龄的增加而增加,经过内科治疗大部分LGIN可以消退,少部分患者出现癌变,在进行胃镜随访的同时要警惕别漏诊其他部位恶性肿瘤。Objective To study clinical pathologic features of gastric low-grade intraepithelial neoplasia(LGIN)and its prognosis.Methods Gastroscopic results were analyzed in 104978 people from May 2012 to May 2017 retrospectively,of which 509 patients with LGIN were diagnosed and 260 patients were followed up.Results The total detection rate of LGIN was 0.95%,of which mild LGIN was 0.87%and moderate LGIN was 0.08%.The patients over 60 years had the highest detection rate,which was 1.5%.The LGIN was mainly in gastric antrum,which was 74.1%.84.5%,42.6%,15.3%and 67.0%were accompanied with chronic inflammation,acute inflammation,gastric atrophy and intestinal metaplasia.Gastric atrophy and intestinal metaplasia were associated with age,location of the lesions and endoscopic presentations(P<0.05).The elimination and canceration rate was 88.8%and 0.4%respectively for mild LGIN,and 68.4%and 10.5%respectively for moderate LGIN.The incidence rate of multiple primary cancer for mild LGIN patients was 0.8%.Conclusion Elimination occurs in most patients after medicine treatment and canceration occurs in fewer patients with LGIN.When the patients are followed up by gastroscopy,we should pay attention to multiple primary cancer.

关 键 词：胃 低级别上皮内瘤变 随访 

分 类 号：R735.2[医药卫生—肿瘤]