胃底腺息肉的临床病理特征及其与雌激素、孕激素的相关性  

Clinical pathological characteristics of fundic gland polyp and their correlation with estrogen and progesterone

作　　者：曹豆豆 年媛媛 韩艳玲 孟宪梅[2] 刘琳[2] 刘晓芳 曹佳馨 曹笑寅 CAO Doudou;CAO Xiaoyin;NIAN Yuanyuan;MENG Xianmei;LIU Lin;HAN Yanling;LIU Xiaofang;CAO Jiaxin(Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014040,China;Department of Gastroenterology,Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014030,China;Department of Pathology,Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014030,China;Department of Gastroenterology,Baotou Eighth Hospital,Baotou 014040,China)

机构地区：[1]内蒙古科技大学包头医学院,014040 [2]内蒙古科技大学包头医学院第二附属医院消化内科,014030 [3]内蒙古科技大学包头医学院第二附属医院病理科,014030 [4]包头市第八医院消化内科,014040

出　　处：《国际消化病杂志》2024年第5期290-295,323,共7页International Journal of Digestive Diseases

基　　金：内蒙古自治区科技计划项目(2021GG0232);内蒙古自治区高等学校科学研究项目(NJZY22057)。

摘　　要：目的分析胃底腺息肉(FGP)的临床病理特征及其与FGP组织中雌激素受体α(ERα)、ERβ、孕激素受体(PR)表达的相关性。方法选择2021年5月至2022年10月在内蒙古科技大学包头医学院第二附属医院接受胃镜检查且组织病理学诊断为FGP的534例患者设为FGP组,另选择同期经胃镜检查且组织病理学诊断为慢性非萎缩性胃炎的175例患者设为对照组。收集入组者的临床资料。随机选取其中42例患者的FGP组织和22例患者的慢性非萎缩性胃炎组织石蜡标本,采用免疫组织化学法检测组织中ERα、ERβ和PR表达水平。采用多因素logistic回归分析探讨FGP发生的影响因素。采用Spearman等级相关分析探讨FGP组织中ERα、ERβ、PR表达的相关性。结果多数FGP的直径<0.5 cm(71.5%);多发性息肉(62.0%)较单发性息肉(38.0%)多见;好发部位为胃体[362例(67.8%)],其次为胃底+胃体[98例(18.4%)];息肉形态以山田Ⅰ型(65.1%)、Ⅱ型(34.3%)为主。FGP患者多合并结直肠腺瘤性息肉(26.2%)、反流性食管炎(21.5%)。FGP组与对照组在性别、年龄,以及有无饮酒史、吸烟史、PPI使用史、Hp感染方面的差异均有统计学意义(P均<0.05)。女性、年龄41~60岁、PPI使用史(>12个月)均是FGP发生的独立危险因素,Hp感染是FGP发生的独立保护因素。FGP组织中ERα、ERβ、PR阳性表达率均显著高于慢性非萎缩性胃炎组织,并且FGP组织中ERα、ERβ、PR表达呈正相关。结论女性、41~60岁、长期服用PPI(>12个月)均是FGP发生的独立危险因素,Hp感染是FGP发生的独立保护因素,ERα、ERβ、PR的表达均与FGP发生有一定相关性。Objective This paper intends to analyze clinical pathological characteristics of fundic gland polyp(FGP)and their correlation with the expression of estrogen receptorα(ERα),ERβ,and progesterone receptor(PR)in FGP tissues.Methods Five hundred and thirty-four patients who underwent gastroscopy and were diagnosed with FGP by histopathology at the Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology from May 2021 to October 2022 were selected and assigned to the FGP group,while a hundred and seventy-five patients who underwent gastroscopy and were diagnosed with chronic non-atrophic gastritis by histopathology during the same period were selected and assigned to the control group,whose clinical data were collected.The FGP tissues of 42 patients and chronic non-atrophic gastritis tissue paraffin specimens of 22 patients were randomly selected,and the expression levels of ERα,ERβ,and PR in the tissues were detected by immunohistochemistry.Multivariate logistic regression analysis was used to explore the influencing factors of FGP occurrence.Spearman rank correlation was used to explore the correlation between ERα,ERβ,and PR expression in FGP tissues.Results The diameter of most FGPs are less than 0.5 cm(71.5%).Multiple polyps(62.0%)are more common than single polyps(38.0%).The most common site of occurrence is the stomach body(362 cases)(67.8%),followed by the stomach fundus+stomach body(98 cases)(18.4%).The morphology of polyps is mainly Yamada typeⅠ(65.1%)and typeⅡ(34.3%).FGP patients often have colorectal adenomatous polyps(26.2%)and reflux esophagitis(21.5%).There are statistically significant differences between the FGP group and the control group in terms of gender,age,history of alcohol consumption,smoking,PPI use,and Hp infection(P<0.05).Female,41-60 years of age,and history of PPI use(>12 months)are independent risk factors for FGP,while Hp infection is an independent protective factor for FGP.The positive expression rates of ERα,ERβ,and PR in FG

关 键 词：胃底腺息肉 雌激素受体Α 雌激素受体Β 孕激素受体 

分 类 号：R573[医药卫生—消化系统]