主要癌前胃炎症性疾病的临床及病理特点分析

The Analysis on the Clinical and Pathological Characteristics of Major Premalignant Gastritis

目的探讨部队特定中老年保健人群主要胃癌前炎症性疾病的发生情况及临床与病理特点,优化此类疾病的预防与诊疗措施。方法 通过研究分析近5年来我院接受电子胃镜检查的中老年人的临床及病理资料,对比主要的癌前胃炎症性疾病:萎缩性胃炎和疣状胃炎的临床表现、病理表现、幽门螺杆菌(Hp)感染率等,分析两类不同胃炎的特性。结果 本组患者中疣状胃炎检出率为8.9%,萎缩性胃炎检出率为10.1%,两者相比无统计学差异。疣状胃炎者恶心、呕吐、上腹痛、黑便或便潜血阳性等症状发生率显著高于萎缩性胃炎患者(P<0.05),而腹胀、食欲不振症状在萎缩性胃炎患者中显著升高(P<0.05)。病理表现萎缩性胃炎患者肠上皮化生发生率显著高于疣状胃炎患者,但上皮内瘤变(不典型增生)发生率及淋巴滤泡形成率显著低于疣状胃炎患者(P<0.05)。两者Hp感染无显著差异(P>0.05)。结论 萎缩性胃炎与疣状胃炎作为具有潜在癌变倾向的胃炎,临床表现具有一定的特征性。疣状胃炎上腹部症状较萎缩性胃炎为重,病理表现炎症反应更重且上皮不典型增生发生率高,可能更具癌变危险,临床需加以重视。

Objective To investigate the clinical and pathological characteristics of major premalignant gastritis for optimizing the therapeutic and preventative measures for these diseases.Methods The cases with varioliform gastritis and atrophic gastritis were selected and analyzed from all of the old military personnels who received the gastrosopic examinations in recent five years in our hospital.The clinical symptoms,the pathological characteristics and the rate of helicaobacter pylori（Hp） infection were compared between the cases with varioliform gastritis and atrophic gastritis.Results The prevalence rates of varioliform gastritis and atrophic gastritis were 8.9% and 10.1% respectively.The incidence rates occurring of abdominal pain,nausea,hearburn and hemafecia in the cases of varioliform gastritis were higher than those with atrophic gastritis cases（P0.05）.The rates of abdominal distention and anorexia were higher in atrophic gastritis cases（P0.05）.The rates of intestinal metaplastia and atypical hyperplasia in the pathological examination in the cases of two types gastritis were sinificant different（P0.05）.Conclusion As premalignant gastritis,the cases with varioliform gastritis and atrophic gastritis could have some particular clinical symptoms.The epigastric symptoms could be more severe and the rate of atypical hyperplasia could be higher in the patients with varioliform gastritis.So varioliform gastritis could be more detrimental and should be paid more attention.