体内贲门组织癌变过程的研究

Study of Carcinogenetic Development of Gastric Cardia Tissue

目的研究早期贲门癌的发生规律。方法在食管癌高发区涉县建立205人的研究队列,利用内镜普查和定位活检的方法,前瞻性观察贲门组织癌变过程中组织病理学变化情况。结果 (1)H.pylori 感染、慢性活动性胃炎和贲门癌在发生位点上具有重叠关系。(2)贲门组织在慢性活动性胃炎背景中组织损伤程度重细胞增殖活跃(ki-67表达增强),肠上皮化生、腺上皮萎缩、腺上皮不典型增生发生率高。(3)贲门组织慢性活动性胃炎的自然转归表现为痊愈、肠化、萎缩、不典型增生。(4)贲门组织不典型增生和粘膜内癌的自然转归具有稳定、减轻、进展等表现形式。结论早期贲门癌的发生起源于组织再生过程,是组织再生不良的表现。

Objective To study the law of development of early cancer of gastric cardia in vivo in public screening.Methods A prospective cohort study on gastric cardiac cancer was held in the high incidence area of cancer of esophagus and stomach in China.205 subjects had been ex- amined regularly by endoscopy to observe gastric cardiac carcinoma developing by taking seria biopsy specimen.All specimens were diagnosed through the normal pathological processes to study the prognosis of pre-cancerous lesion of gastric cardiac.Results (1)H.pylori infection, chronic active gastritis,and early gastric cardiac carcinoma happens in same area.(2)Tissue with chronic gastritis was hurt more seriously, and the ki-67 that means cell growing actively expressed more highly.(3)The developing end of chronic active gastritis can be healed,or be glandular atrophy,or be atypical hyperplasia.(4)Atypical hyperplasia and early gastric cardiac cancer without any treatment can show no change,or advanced,or withdrawal.Conclusions The development of early cancer of gastric cardia would proceed through the reproductive pro- cedure of gastric cardia tissue.