放大内镜下胃小凹形态学分类及其临床病理意义  

Magnifying endoscopic classification of gastric pits and their clinicopathological significance

作　　者：黄永辉[1] 周丽雅[1] 林三仁[1] 金珠[1] 刘建军[1] 丁士刚[1] 夏志伟[1] 段丽萍[1] 常红[1] 

机构地区：[1]北京大学第三医院,北京100083

出　　处：《中国内镜杂志》2004年第3期14-16,19,共4页China Journal of Endoscopy

摘　　要：目的　探讨放大内镜下胃小凹的形态分类及其临床病理意义。方法　应用FujinonEG4 85ZH型放大内镜对 10 0例因消化不良症状就诊的患者进行了检查 ,通过分析内镜观察到的胃黏膜细微结构的改变 ,制订出A型 (圆点状 )、B型 (线状 )、C型 (稀疏而粗大的线状 )、D型 (斑块状 )、E型 (绒毛状 )的 5型胃小凹形态分类 ,并与相应部位活检所获得的 4 17个病变组织的病理组织学改变进行了比较分析。结果　A ,B ,C ,D和E 5型分别见于从正常到重度萎缩、重度肠化生的胃黏膜 ,并与慢性炎症及肠化生的程度呈明显正相关 ,异型增生主要见于D型和E型黏膜。结论　 5种基本胃小凹形态与病理组织学改变存在密切关系 ,通过放大内镜准确识别 5种胃小凹的基本形态将有助于对萎缩、肠化生及异型增生等常见胃黏膜病变的诊断。Objective: To explore the classification of gastric pits under magnifying endoscopy and their clinicopathological significance.Methods:One hundred patients with dyspepsia were examined by magnifying endoscope. After analysizing the microstructure of gastric mucosa,the morphology of gastric pits was classified as follows: type A(round spot pits),type B(linear),type C(sparsely and thickly linear),type D(patchy) and type E(villous),which were compared to the histopathological fingdings of 417 biopsies from gastric mucosa. Results:Types A,B,C,D,E were respectively found from normal gastric mucosa to mucosa with severe atrophy and intestinal metaplasia,and the positive correlation was found between types A,B,C,D,E and the degree of chronic gastritis or intestinal metaplasia. Dysplasia was mostly found in gastric mucosa of type D and type E.Conclusion: Five types of gastric pits were closely related to histopathologic findings,and the identification of gastric pits through magnifying endoscopy would help in the diagnosis of the common gastric mucosal lesions including atrophy,intestinal metaplasia and dysplasia.

关 键 词：放大内镜 胃小凹 病理 

分 类 号：R322.4[医药卫生—人体解剖和组织胚胎学]