体检人群^(14)C呼气检测阳性跟踪随访与胃癌的相关性  

A Correlational Study of^(14)C Breath and Gastric Cancer Amongthe Medical Examination Population

作　　者：杨骥 王嫱 YANG Ji;WANG Qiang(Physical Examination Center of the Affiliated Hospital of Yunnan University(The Second People’s Hospital of Yunnan),Kunming 650021,China)

机构地区：[1]云南大学附属医院(云南省第二人民医院)体检中心,云南昆明650021

出　　处：《标记免疫分析与临床》2022年第8期1354-1358,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的通过对健康体检者进行^(14)C呼气试验呈现幽门螺旋杆菌阳性者进一步进行胃镜病理组织学检查,对感染幽门螺旋杆菌(Hp)人群与胃癌的相关性进行研究。方法选取2020年1月至2020年12月在云南大学附属医院(云南省第二人民医院)体检中心进行健康体检并检测^(14)C呼气试验(^(14)C-UBT)呈现Hp阳性者,共800例,对幽门螺旋杆菌阳性受试者进行胃镜病理组织学检查,取组织(分别在胃窦前后壁和胃体前后壁各取1块)进行病理切片染色,查找Hp;并根据病理学活检结果,将其不同病理特征进行标记,标记为正常胃黏膜、慢性活动性胃炎、慢性浅表性胃炎、消化性溃疡、萎缩性胃炎、肠化生和胃癌病例数,并跟踪随访,分析Hp阳性与胃癌的相关性。结果在800例幽门螺旋杆菌阳性受试者中,胃镜病理组织学检查,具有病理特征的病例数347例,占比43.4%(347/800),其中男性160例,女性187例,平均年龄44.6±4.5岁。评估癌前病变与胃癌风险分期方法,不同病理阶段慢性活动性胃炎211例,慢性浅表性胃炎55例,消化性溃疡33例,慢性萎缩性胃炎13例,肠化生18例,异型增生14例,胃癌3例。其中与胃癌相关性强是慢性萎缩性胃炎、肠化生、异型增生,也就是可能会发生胃癌的近13.8%(48/347),已经发展至胃癌0.9%(3/347)。对347例受试者幽门螺旋杆菌阳性进行临床干预治疗,进行为期1年的跟踪随访,其中195例随访胃镜组织学检查胃黏膜正常,好转率56.2%(195/347),其中与胃癌相关性强的慢性萎缩性胃炎好转4例,肠化生好转6例,异型增生好转6例,1例胃癌手术治疗后好转。结论通过评估癌前病变与胃癌风险分期,在不同病理阶段其中与胃癌相关性强的是慢性萎缩性胃炎,相关性较强的是肠化生和异型增生,且不可逆转。对胃癌进行有效的预防和控制,要以预防为重点,加强人群Hp体检与干预,加强胃癌筛查和早诊早治,降低胃癌发�Objective To study the relationship between Helicobacter pylori(Hp)infection and gastric cancer in healthy patients who underwent^(14)C breath test and showed positive results of Hp.Methods A total of 800 Hp positive subjects were selected from the Physical Examination Center of Yunnan University Affiliated Hospital(The Second People’s Hospital of Yunnan Province)during January,2020 to December,2020 who underwent^(14)C breath test(^(14)C-UBT),and then the positive subjects of Hp were examined by gastroscopic histopathology.Tissues were collected from the front and back walls of gastric antrum for pathological section staining to identify Hp.According to the pathological biopsy results,the different pathological features were marked as the number of normal gastric mucosa,chronic active gastritis,chronic superficial gastritis,peptic ulcer,atrophic gastritis,intestinal metaplasia and gastric cancer.These patients were followed up,and the correlation between Hp positive and gastric cancer was analyzed.Results Among 800 Hp positive subjects,347 cases(43.4%(347/800))with pathological features were detected by gastroscopic histopathology,including 160 males and 187 females,with an average age of 44.58±4.51 years.The risk staging method of precancerous lesions and gastric cancer was used to evaluate patients,leading to 211 cases of chronic active gastritis,55 cases of chronic superficial gastritis,33 cases of peptic ulcer,13 cases of chronic atrophic gastritis,18 cases of intestinal metaplasia,14 cases of dysplasia and 3 cases of gastric cancer.Among them,chronic atrophic gastritis,intestinal metaplasia and dysplasia were strongly correlated with gastric cancer,indicating the likelihood of gastric cancer was nearly 13.8%(48/347),which had developed to 0.9%(3/347).347 patients with positive Hp were treated with clinical intervention and followed up for one year,among whom,195 were followed up by endoscopic histological examination of normal gastric mucosa,and the improvement rate was 56.2%(195/347).There were four case

关 键 词：健康体检 幽门螺旋杆菌 胃镜 慢性活动性胃炎 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]