胃黏膜肠上皮化生的研究进展

Research Progress of Gastric Intestinal Metaplasia

目的总结胃黏膜肠上皮化生的研究进展。方法采用文献复习的方法 ,对有关胃黏膜肠上皮化生研究进展的文献进行综述。结果胃黏膜肠上皮化生的重要特征是杯状细胞的出现,其发生与幽门螺杆菌感染、胃溃疡、胆汁酸反流、年龄、超重等因素有关。清除幽门螺杆菌、个体化药物干预及定期的内镜监测是有效的防治手段。胃黏膜肠上皮化生被认为是胃癌的癌前病变,但其发生机理及其在胃癌形成过程中的作用机理并不明确。结论胃黏膜肠上皮化生与胃癌的关系已比较明确,但其在胃癌发生中的作用机理、个体化防治及内镜监测策略的制定,仍需要多中心、大型的临床研究进一步探索。

Objective To summarize the research progress of gastric intestinal metaplasia （GIM）. Methods The literatures about the research progress of the GIM were reviewed. Results The most important histological feature of GIM was the presence of goblet cells, which was associated with the risk factors of Helicobacterpylori, gastric ulcer, reflux of bile acid, old age, overweight, and so on. Eradication of Helicobacter pylori, individual drug intervention, and regular endoscopic surveillance were considered to be effective prevention and treatment measures. GIM was recognized as the precancerous lesion of gastric cancer, however, the pathogenesis of GIM in gastric carcinogenesis had not been recognized so far. Conclusions It has a relationship between GIM and gastric cancer. The mechanism of GIM, the pathogenesis of GIM in gastric cancer, individual therapy measures, and the formulation of endoscopic surveillance strategy, however, still need further multicenter and large clinical study.