胃粘膜肠上皮化生类型与胃癌发生的关系

Analysis on the relationship between intestinal metaplasia and gastric carcinoma with AB-PAS and HID-AB mucin histochemical techniques

目的寻找与胃癌发生有密切关系的肠上皮化生的类型，为胃癌早期诊断提供可靠的理论依据。方法应用ＡＢ－ＰＡＳ、ＨＩＤ－ＡＢ粘液组织化学方法，区别癌旁组织和背景粘膜组织伴有肠上皮化生的类型。结果 ①３９例胃癌组织当中，癌旁伴有肠上皮化生的为３１例，背景粘膜伴有肠上皮化生的为２５例。②癌旁肠上皮化生的ＡＢ－ＰＡＳ染色， １００％阳性； ＨＩＤ－ＡＢ染色，８７．１％阳性。背景粘膜肠上皮化生ＡＢ－ＰＡＳ染色， １００％阳性； ＨＩＤ－ＡＢ染色， ４０％阳性。③３１例癌旁组织的肠上皮化生中，７４．２％为不完全大肠型；２５例背景粘膜的肠上皮化生当中，５２％为不完全小肠型和３２％为不完全大肠型。结论癌旁组织的不完全大肠型肠上皮化生与胃癌的发生有密切关系。背景粘膜组织当中的小灶状不完全大肠型肠上皮化生，具有潜在发生癌变的可能性。

Objective To study the relationship between intestinal metaplasia(IM) and gastric carcinoma. Methods Two mucin histochemical techniques, alcian blue-pH2.5-periodic acid-schiff(AB-PAS) and highiron-diamine-alcian blue-pH2. 5(HID-AB) were applied to differentiate the type of IM in adjacent mucosa and background mucosa of gastric carcinoma. Results ①Among 39 cases of samples, the adjacent mucosa was accompanied by IM in 31 cases, the background mucosa was accompanied by IM in 25 cases; ②IM in the adjacent mucosa, positive rate was 100% with AB-PAS, 87. 1% with HID-AB. IM in the background mucosa, positive rate was 100% with AB-PAS, 40% with HID-AB; ③Among 31 cases of IM in the adjacent mucosa, incomplete colonic type accounted for 74. 2%. Among 25 cases of IM in backgroung mucosa, incomplete small intestinal type accounted for 52%, incomplete colonic type 32%. Conclusion Incomplete colonic type of IM in the adjacent mucosa has a close relationship with the development of gastric carcinoma, and spot incomplete colonic type of IM in the background mucosa has an underlying possibility to develop cancer.