贲门癌癌旁组织肠上皮化生检测

Incidence of intestinal metaplasia adjacent to gastric cardia adenocarcinoma

目的:探讨贲门癌(GCA)癌旁肠上皮化生(IM)的组织学和组织化学特征及其与病变的关系。方法:采用爱显蓝-雪夫试剂染色和高铁二胺-爱显蓝染色2种方法分析408例河南GCA高发区GCA癌旁组织IM的分布特征。结果:GCA癌旁IM的检出率为32%(130/408),Ⅰ、Ⅱ和Ⅲ型IM所占比例分别为65%、16%和19%,Ⅰ型多于其他2型(χ2=86.146,P<0.05)。IM伴不典型增生的比例(88%)高于伴慢性浅表性胃炎(13%)和慢性萎缩性胃炎(30%)(P<0.05)。结论:GCA癌旁IM的发生率随癌前病变的加重逐渐升高,提示其可能是一种重要的GCA癌前病变。

Aim ： To explore the histological and histochemical features of intestinal metaplasia （IM） adjacent to gastile cardia adenocarcinoma （GCA） and its correlation with gastric cardia epithelial lesions. Methods： A total of 408 cases of GCA from high-incidence area in Henan were subjected to determine IM in tissue adjacent to GCA using histochemical staining methods （AB-PAS and HID-AB）. Results： The detection rate of IM in tissue adjacent to GCA was 32% （ 130/ 408）. The rates of type Ⅰ , Ⅱ and Ⅲ of IM were 65% , 16% , and 19% , respectively. IM occurred more frequently in dysplasia （88%） than in chronic superficial gastritis （13%） and chronic atrophy gastritis（30% ） （P 〈 0.05 ）. Conclusion： The detection rate of IM in tissue adjacent to GCA increases with the aggravation of the lesion, which suggests that IM may be one of the important precancerous lesions for GCA.