慢性胃病伴肠上皮化生、胃癌与幽门螺旋杆菌感染的关系

The Association of Chronic Gastropathy with Intestinal Metaplasia Gastric Carcinoma with Helicobacter Pylori Infection

目的探讨慢性胃病伴肠上皮化生、胃癌与幽门螺旋杆菌(helicobacter pylore,HP)感染的关系。方法采用warthin-strarry银染色方法,对380例慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡组织及胃癌的癌旁组织进行HP检测,应用(alcian blue-PH2.5-periodic-schiff,AB-PAS)、(high-iron-diamine-alcian blue-PH2.5,HID-AB)黏液组织化学方法,区别慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡组织及胃癌的癌旁组织伴有肠上皮化生的类型。结果总例数380例,HP阳性率为69.74%。慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡组织及胃癌的癌旁组织伴肠上皮化生的HP感染率分别为77.78%、85.71%、100.00%、80.95%。慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡及胃癌的癌旁组织伴肠上皮化生AB-PAS染色阳性率分别为86.84%、91.43%、93.33%、100.00%;HID-AB染色阳性率分别为34.21%、42.86%、53.33%、85.71%。癌旁组织的肠上皮化生中,78.57%为不完全大肠型,慢性浅表性胃炎、慢性萎缩性胃炎、胃溃疡伴肠上皮化生中,不完全小肠型比例分别为52.63%、54.28%、53.33%;不完全大肠型比例分别为28.95%、31.43%、20.00%。结论HP感染与慢性胃病伴肠上皮化生及胃癌的发生密切相关。癌旁组织的不完全大肠型肠上皮化生与胃癌的发生密切相关;慢性胃病组织当中的小灶状不完全大肠型上皮化生具有潜在发生癌变的可能性。

Objective To study the associations chronic gastropathy gastrice with intestinal cetaplasia carcinona with Heclicobacter pylori infection. Methods Helicobacter pylori infection was examined by warthin-starry staining in 380 cases chronic superficial gastritis,chronic atrophic gastritis, gastric ulcer tissue and adjacent mucosa of gastric carinoma, two mucin histo- chemical technique, alcian blue-PH2.5-periodic - schiff（AB-PAS） and high-iron-diamine-alcian blue-PH2.5 （HID-AB） were applied to differentiate the type of intestinal metaplasia with chronic superifical gastritis,chronic atrophic gastritis, gastric ulcer and adjacent mucosa of gastric carcinoma. Results Of 380 cases,the positive rate of Helicobacter pylori was 69.74%. In chronic superficial gastritis, chronic atrophic gastritis, gastric ulcer tissue and adjacent mucosa of gastric carcinoma, the positive rates of Helicobacter pylori were 73.78%, 85.71%, 100.00% and 80.95 %, respectively. The positive rates of AB - PAS staining were 86.84% ,91.43% ,93.33% and 100.00% ;and the positive rates of HID -AB staining were 34.21% ,42.86% ,53.33% and 85.7% respectively. In intestinal metaplasia of the adjacent mucosa of gastric carcinoma, incomplete colonic type accounted for 78.5% whereas in intestinal metaplasia with chronic superficial gastritis, chronic atrophic gastritis and gastric ulcer,incomplete small intestinal type accounted for 52. 63%, 54.28% and 53. 33%, and incomplete colonic type accounted for 28.95%, 31.43 % ,20.00%, respectively. Conclusion Helicobacter pylori infection has a close relationship with intestinal metaplasia with chronic gastropathy and gastric carcinoma ;Incomplete colonic type of intestinal metaplasia in the adjacent mucosa has a close relationship with development of gasteric carcinoma; and spot incomplete colonic type of intestinal metaplasial in the tissue of chronic gastropathy has an underlying possibility to develop cancer