慢性萎缩性胃炎的胃镜与病理特点分析  

Analysis of gastroscopy and pathological characteristics in chronic atrophic gastritis

作　　者：汤进芝 石嫦娥[1] 周娟燕 唐敏 汪文生 TANG Jinzhi;SHI Chan’ge;ZHOU Juanyan(Department of Gastroenterology,the First Affiliated Hospital of Anhui Medical University,Anhui,Hefei 230012,China)

机构地区：[1]安徽医科大学第一附属医院消化内科,合肥市230012 [2]安徽省公共卫生临床中心

出　　处：《河北医药》2024年第5期713-716,共4页Hebei Medical Journal

基　　金：安徽医科大学校科研基金(编号:2019xkj059)。

摘　　要：目的探讨胃镜诊断与病理诊断慢性萎缩性胃炎患者的符合率,以及不同萎缩程度及不同年龄组的病理特点。方法收集2020年6月至2021年8月经胃镜诊断为慢性萎缩性胃炎患者534例,统计一般资料、胃镜及病理报告、幽门螺旋杆菌检测情况。结果经胃镜诊断为慢性萎缩性胃炎患者共534例,经病理诊断为慢性萎缩性胃炎患者共370例,其内镜与病理诊断的符合率为69.29%。慢性萎缩性胃炎好发于老年人,男女性别比较差异无统计学意义(P>0.05)。慢性萎缩性胃炎组中幽门螺旋杆菌的感染率与慢性非萎缩性胃炎组比较差异有统计学意义(P<0.05)。胃窦的萎缩、肠化和低级别上皮内瘤变检出率高于胃角和胃体及其他部位,而在高级别上皮内瘤变方面,胃底及贲门检出率较高。慢性萎缩性胃炎组中萎缩的程度与肠化、上皮内瘤变程度密切相关。重度萎缩组中的重度肠化和上皮内瘤变比轻度及中度萎缩组发生率高。在不同年龄组中比较,老年组的肠化及上皮内瘤变发生率较高(P<0.05)。结论胃镜与病理诊断为慢性萎缩性胃炎的符合率偏低,胃窦是萎缩、肠化的好发部位;肠化及上皮内瘤变的发生与萎缩程度呈正相关,老年人的萎缩、肠化及上皮内瘤变发生率高。Objective To analyze the coincidence rate between gastroscopy and pathologic diagnosis in chronic atrophic gastritis,and explore pathological characteristics of different degree of atrophy and different age groups.Methods From June 2020 to August 2021,the basic data,gastroscopy and pathological reports,Helicobacter pylori infection data were collected form recruited 534 patients with suspected chronic atrophic gastritis diagnosed by gastroscopy.Results A total of 370 patients with chronic atrophic gastritis were diagnosed by pathology,and the coincidence rate between gastroscopy and pathologic diagnosis was 69.29%.Chronic atrophic gastritis was more common in the elderly,and there was no significant difference between men and women(P>0.05).The infection rate of Helicobacter pylori in chronic atrophic gastritis group was 45.95%,which was significantly different from that of chronic non-atrophic gastritis(P<0.05).The detection rates of atrophy,intestinal metaplasia and low-grade intraepithelial neoplasia of gastric antrum were higher than those of gastric angle,gastric body and other sites.The detection rates of high-grade intraepithelial neoplasia in the gastric fundus and gastric cardial were higher.The degree of atrophy in the chronic atrophic gastritis group was closely related to the degrees of intestinal neoplasia and intraepithelial neoplasia.The incidences of severe intestinal neoplasia and intraepithelial neoplasia were higher in the severe atrophy group than those in the mild and moderate atrophy groups.The incidences of enteralization and intraepithelial neoplasia in the elderly were the highest among different age groups(P<0.05).Conclusion For patients with chronic atrophic gastritis,the coincidence rate between gastroscopy and pathologic diagnosis is low.Gastric antrum is prone to atrophy and intestinal metaplasia.The incidences of intestinal metaplasia and intraepithelial neoplasia are positively related with atrophy.The incidence of atrophy,intestinal metaplasia and intraepithelial neoplasia in the e

关 键 词：慢性萎缩性胃炎 胃镜 病理 肠化 上皮内瘤变 

分 类 号：R573.32[医药卫生—消化系统]