小儿慢性胃炎内镜表现与病理组织学改变的相关性研究

Relationship between gastroscopic manifestations and histopathologic changes in children with chronic gastritis

目的探讨小儿慢性胃炎内镜表现与胃黏膜病理组织学改变的关系。方法回顾性分析2003年1月至2007年3月浙江省金华市中心医院收治的213例患儿胃镜下8种主要表现;按慢性炎症、炎症活动性、萎缩、肠化生、异型增生、黏膜糜烂6种类型进行病理评价,研究内镜表现和病理诊断的相关性。结果胃镜诊断慢性浅表性胃炎(CSG)207例,慢性萎缩性胃炎(CAG)6例。213例均送病理学检查,病理诊断CSG196例,轻度CAG11例,正常胃黏膜6例。胃镜与病理学诊断CSG和CAG总符合率分别为91.08%和93.89%。胃镜诊断CSG的镜下主要表现为黏膜充血水肿和红白相间,以红为主,对病理CSG的诊断灵敏度分别为86.22%和81.12%,特异度为47.06%(P<0.05);CAG的胃镜诊断对病理的诊断灵敏度为18.18%,特异度为98.01%(P<0.05)。结论儿童CSG胃镜下主要表现对病理CSG的诊断灵敏度较高,具明显的相关性,而CAG的胃镜诊断对病理CAG的诊断灵敏度较低。

Objective To evaluate the endoscopic results of chronic gastritis in children and their pathlogieal diagnosis. Methods A total of 213 cases of chronic gastritis were retrospectively analyzed. After endoscopy, histological diagnosis was classified as chronic inflammation, polymorphonuclear neutrophil infiltration, glandular atrophy, intestinal metaplasia, dysplasia and erosion. Results A total of 207 cases were chronic superficial gastritis （ CSG ）diagnosed by gastroseopy, while 6 of them were chronic atrophic gastritis （CAG）. A total of 196 patients were CSG diagnosed by histopathology, while 6 of them were normal. The consistency rate of CSG and CAG diagnosed by gastroseopy and histopathology was 91.08%. For CSG,the sensitivity of hyperaemia,a red and white colour but red dominant mucosa under gastroseopy comparing with histopathology,was 86. 22% and 81.12% , respectively. For CAG, the sensitivity of a red and white eolour but white dominant mueosa, exposed vessel under gastroseopy eompard with histopathology was 18.18% , respectively. Conclusion The sensitivity of major manifestations under gastroscopy eompard with histopathology for CSG is higher,but that for CAG is lower. Endoscopic diagnosis for CSG has certain correlation with histological diagnosis in children.