摘要
目的观察胃癌（ＧＣ）的发生过程．方法在胃癌高发区山东省临朐县，对一组有胃粘膜病理诊断结果的自然人群进行随访观察，并配以嵌套式病例对照研究．结果胃粘膜肠上皮化生（ＩＭ）和异型增生（Ｄｙｓ）发生胃癌的危险性显著高于慢性萎缩性胃炎（ＣＡＧ），且在胃中不同部位的检出率与胃癌在相应部位发生的频率存在正等级相关关系；Ｄｙｓ发生胃癌所需要的时间明显短于ＩＭ发生胃癌所需要的时间．结论胃癌特别是肠型胃癌是在ＣＡＧ基础上发生ＩＭ，进而产生Ｄｙｓ。
AIM To observe the process of gastric mucosa carcinogenesis. In an area with a high rate of gastric cancer (GC), a large population with histological diagnosis of gastric mucosa were followed up and a nested case control study was carried out. RESULTS The risk of GC was extremely higher in intestinal metaplasia (IM) and dysplasia (Dys) than in chronic atrophic gastritis (CAG). There was a positive rank correlation between IM, Dys and GC in anatomic distribution. The time between Dys and GC was shorter than between IM and GC. CONCLUSION The pathogenesis of GC (especially the intestinal type) involves a multistep process, i.e., from CAG to IM, Dys and finally to carcinoma.
关键词
胃肿瘤
病理学
癌前状态
胃粘膜
增生
stomach neoplasms/pathology
precancerous conditions
gastric mucosa/pathology
metaplasia
hyperplasia
