深在性囊性胃炎合并早期胃癌的内镜和病理特征分析  

Endoscopic and pathological analysis of patients with early gastric cancer and comorbid gastritis cystica profunda

作　　者：牛森森 金树[1] 常前平 周玉保[1] NIU Sensen;JIN Shu;CHANG Qianping;ZHOU Yubao(Department of Gastroenterology,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院消化内科,合肥230601

出　　处：《临床肿瘤学杂志》2023年第12期1046-1049,共4页Chinese Clinical Oncology

摘　　要：目的探讨深在性囊性胃炎(GCP)合并早期胃癌的内镜下表现和临床病理特征。方法选取2018年1月至2023年3月本院诊治且术后病理证实为GCP合并早期胃癌的病例,对白光内镜、超声内镜下表现和临床病理特征等资料进行总结分析。结果22例GCP合并早期胃癌患者中男性20例、女性2例,中位年龄70岁;17例合并幽门螺杆菌感染,术前均无胃部手术史,病变部位贲门19例、胃体3例;白光内镜下以平坦型表现为主,超声内镜检查第一层增厚8例,第三层增厚7例,探及黏膜下囊状低回声区7例;22例均行内镜下黏膜剥离术(ESD),术后病理为分化型管状腺癌22例,治愈性切除18例,非治愈性切除4例。结论GCP合并早期胃癌好发于老年男性,内镜下以平坦型表现为主,好发部位为贲门,术后病理多为黏膜内中分化管状腺癌,超声内镜探及黏膜下囊状低回声区对GCP合并早期癌的诊断有一定帮助,ESD治疗早期胃癌合并GCP安全有效。Objective To analyze the endoscopic manifestations and clinicopathological features of patients with early gastric cancer and comorbid gastritis cystica profunda(GCP).Methods From January 2018 to March 2023,patients diagnosed and treated in our hospital with postoperative pathological confirmation as early gastric cancer and comorbid GCP were enrolled.The data of white light endoscopy,ultrasound endoscopic manifestations and clinicopathological features were summarized and analyzed.Results Among the 22 patients of early gastric cancer and comorbid GCP,there were 20 males and 2 females,with a median age of 70 years.There were 17 cases of Helicobacter pylori infection.None of them had a history of gastric surgery before the operation,with 19 cases of lesions located in the cardia and 3 cases in the gastric body.Under white light endoscopy,the main presentation was flat.Endoscopic ultrasound examination showed thickening of the first layer in 8 cases,thickening of the third layer in 7 cases,and exploration of the submucosal cystic hypoechoic area in 7 cases.All 22 cases underwent endoscopic mucosal dissection(ESD).Postoperative pathology revealed 22 cases of differentiated tubular adenocarcinoma,with 18 cases undergoing curative resection and 4 cases undergoing non curative resection.Conclusion GCP combined with early gastric cancer is more common in elderly males,with a flat appearance under endoscopy.The most common site is the cardia,and the postoperative pathology is mostly moderately differentiated tubular adenocarcinoma within the mucosa.Ultrasound endoscopic exploration of the submucosal cystic hypoechoic area is helpful in the diagnosis of early cancer combined with GCP.ESD treatment for early gastric cancer combined with GCP is safe and effective.

关 键 词：深在性囊性胃炎 早期胃癌 超声内镜 内镜下黏膜剥离术 

分 类 号：R735.2[医药卫生—肿瘤]