幽门螺旋杆菌、胃泌素与胃癌癌前病变关系的临床病理学研究

A Clinical Pathological Study of the Relationship between Helicobacter Pyloric and Serum Gastrin in Carcinoma of Stomach Precancerous Lesions

目的 :探讨幽门螺旋杆菌 (HP)及空腹血清胃泌素 (SG)与胃粘膜肠腺化生、萎缩和不典型增生三种癌前病变的关系。方法 :对患者先行空腹 SG测定 ,再作胃镜检查 ,取胃窦粘膜作快速尿素酶试验 (HPUT)、Giemsa染色及病理组织学检查。结果 :HP(+)组 SG明显高于 HP(- )组 (P <0 .0 5 ) ,病理组织学检查三种癌前病变明显异常 ,治疗后 HP转阴组较非转阴组 SG明显下降 (P <0 .0 5 ) ,组织学检查胃粘膜中性粒细胞浸润减少。结论 :HP是胃癌癌前病变的主要原因 ,其刺激胃泌素释放增多 ,导致胃粘膜炎症、肠腺化生、萎缩、不典型增生。

Objective:To study the fasting serum gastrin (SG)level in patient with Superficial Gastritis inteslinal metaplasia,atrophic and severe atypical hyperplasia of three carcinoma of stomach precancerous lesions,which was divided into helicobacter pylori (HP) positive group and helicobacter pylori negative group.Methods:Sixty cases of patients with precancerous lesions was diagnosticated by gastroscopy and rapid ureas test was taken,giemsa staining pathological examination on the histological biopsy from antral mucosa to differential cases in HP(+) group or HP(-) group conducted as well.Results:The SG level in HP(+) group was higher than that in HP(-) group significantly (P<0.05).The pathological examination on the histological hyperplasia showed that precancerous lesions are notable higher.After antibiotic therapy, the SG level of HP positive group was also higher than the group in which HP have had conversed to negative and pathological examination showed that the neutrophil infilration of antral mucosa decreased significantly.Conclusion:The infection of HP is the main causative agent in most cases of carcinoma of stomach precancerous lesions.It stimulates the G cell and increases SG releasing the major etiologic mechanism of inteslinal metaplasia atrophic atypical hyperplasia.