胃癌前病变黏膜微细结构形态变化与组织学改变相关性研究

Study on the Relationship Between Histopathologic Findings and Mucosal Microstructural Changes in Ggastric Premalignant Lesions

目的研究染色放大内镜下胃癌前病变黏膜小凹及微血管的变化与病理组织学的相关性,探讨放大内镜用于诊断癌前病变的可能性。方法应用O lympus G IF-Q240Z放大内镜对256例胃癌前病变黏膜进行观察,局部喷洒0.4%靛胭脂染色后利用其放大功能观察胃小凹形态及微血管改变并记录。在观察及记录区内取材送病理组织学检查。结果 256例患者中,肠上皮化生及异型增生黏膜胃小凹形态主要表现为E型(91.5%)和F型(87.1%)。根据胃黏膜小凹形态及微血管特征,色素放大内镜下对胃黏膜肠上皮化生及异型增生的镜下诊断符合率分别为87.5%及80.6%。结论胃小凹形态及其微血管改变有助于临床对胃黏膜病变性质的判断。

Objective To investigate the relationship between histopathologic findings and gastric mucosal pits and microvessels in gastric premalignant lesions, study the usefullness of magnifying endoscopy for the diagnosis of gastric premalignant lesions. Methods Gastric mucosa of 256 patients with gastric premalignant lesions were observed by Olympus GIF-Q240Z magnifying endoscopy,0.4% indigo carmine was sprayed to observed the gastric pits and microvessels. Biopsies were taken from the magnified sites. Results Gastric mucosal pits in 256 cases with intestinal metaplasia and dysplasia were predominantly shown as type E （91.5 % ）and type F （87.1% ） respectively. The accuracy of diagnosis on intestinal metaplasia and dysplasia in gastric mucosa by using magnifying chrontoendoscopy was 87.5% and 80.6% respectively according to the characteristics of gastric mucosal pits and microvessels. Conclusion The shape of gastric pits and microvessels would help in the diagnosis of the gastric mucosal lesions.