活检胃粘膜灶性异型增生的形态特征及其意义的研究

A study of morphology in focal dysplasia of gastritis and its significance

对３９６例活检胃粘膜炎症性病变进行了形态学观察，发现有１９．９％的病例在腺管上皮的某一处，病变小者仅有单个细胞，多者达１０余个细胞，多数２个至５个细胞的异型增生灶，可向管腔内或基底膜外突起，极性紊乱，拥挤镶嵌排列。细胞体积增大，尤以核增大明显，核染色质粗，核形态大小不等，圆形、椭圆形或不规则的奇异形，可见核仁，这种现象我们称之为灶性异型增生细胞。其检出率为糜烂性胃炎８．０％（７／８８），浅表性胃炎１０．９％（１１／１０１），萎缩性胃炎３８．４％（４３／１１２），慢性溃疡１８．９％（１８／９５）。灶性异型增生细胞ＰＣＮＡ阳性表达６１．３％，ＡｇＮＯＲ计数３．８１个至８．７２个之间，一些银颗粒增大、不规则。提示胃粘膜灶性异型增生病变可看作是一种癌前期病变。

The morphology of gastric mucosa biopsies taken from 396 cases with various gastritis or gastric ulcer was studied pathologically.It was found that in 19.9%(79/396) of the cases there was focal dysplasia in somewhere in the glandulous tubule.Most of them have 2￣5 focal dysplastic cells,some have only one and others have more than 10.They protrude into the glandular cavity or out of the basement membrane.They are of polarity disturbance and packed in mosaic arrangement.The dysplastic cell volume is large and especially large is the nucleus in which coarse.chromatin and nucleolus can be seen.The nucleus is various in shape round,oval or quite irregular.The detectable rate of focal dysplasia is 8.0% (7/88) in erosive gastritis,10.9% (ll/l0) in superficial gastritis,38.4% (43/112) in atrophic gastritis,and 18.9% (18/95) in chronic gastric ulcer.The positive reaction of the focal dysplastic cells to PCNA reaches 61.3% and the counts of AgNOR granules are between 3.8l and 8.72.Some silver granules become large and irregular.The pathological lesions of focal dysplasia of gastritis can be regarded as a kind of precarcinomatous change.