早期胃癌形态学表现和诊断体会

Morphological Manifestations and Diagnostic Experiences of Early Gastric Cancer

胃黏膜活检是早期胃癌,尤其是微小癌最有效的诊断手段。胃癌早期时肉眼形态常不典型,表现为胃炎样癌、小胃癌、微小或片状糜烂、息肉癌变、假性愈合等,胃镜下较难判断其良、恶性。近年来,这类胃癌的比例逐年增多。质子泵抑制剂的广泛应用,使部分早期胃癌病灶产生假性愈合,加大了诊断难度,使有些患者经多次活检仍不能确诊,从而延误治疗。黏液染色对早期胃癌的病理诊断帮助很大,尤其是当活检标本中癌细胞数量很少时。本文详述早期胃癌的形态学表现和诊断体会。

Gastric mucosa biopsy is the most effective diagnostic means for early gastric cancer （EGC）, especially the minimum cancer. The macroscopic morphology of EGC is often not typical, such as gastritis-like cancer, tiny gastric cancer, small or sheet erosion, polyp caneeration and pseudo-healing. And it is more difficult to judge its benign or malignant nature under the gastroscnpe. The proportion of such kinds of EGC is increasing gradually in recent years. Also, with the wide application of proton pump inhibitors, part of EGC lesions demonstrate pseudo-healing, which increases the diagnostic difficulty and make some patients hard to be identified by repeated biopsy, thus delaying the treatment timing. Mucus staining is helpfnl for the pathologic diagnosis of EGC, especially when few cancer cells are presented in the biopsy specimens. This article reviewed the detailed morphological manifestations and diagnostic experiences of EGC.