2178例胃息肉的临床病理特征

Clinical and Pathological Characteristics of Gastric Polyps:An Analysis of 2178 Cases

目的:分析胃息肉临床、胃镜和病理特点,为胃息肉临床诊断和治疗提供指导。方法:对2012年01月至2014年12月武汉大学中南医院消化内镜中心检出的胃息肉患者的临床、胃镜、病理资料进行回顾性分析。结果:共检出胃息肉患者2 178例,检出率7.5%,男性833例(38.2%),女性1 345例(61.8%),年龄在14-95岁之间,高发年龄段为40-70岁(76.3%,1 662/2 178),单发息肉1 372例(63.0%),多发息肉806例(37.0%);息肉主要位于胃体和胃底(71.5%),直径多≤0.5cm,共为1 761例(79.9%,1 741/2 178);病理分型中炎性增生性息肉1 231例(56.5%)、胃底腺息肉903例(41.5%);山田Ⅰ、Ⅱ型共1 973例(90.6%)。结论:胃息肉的检出率逐年升高,病理谱正发生改变,炎性增生性息肉比例在下降,胃底腺息肉比例在升高;贲门息肉易漏诊,癌变率较高,因此应加强对贲门部病变的观察和随访。

Objective：To analyze the clinical,endoscopic and pathological characteristics of gastric polyps to provide instructions to the clinical diagnosis and treatment of gastric polyps.Methods：We retrospectively analyzed the clinical data,endoscopic results and pathological data of gastric polyps detected in digestive endoscopy center of Zhongnan Hospital of Wuhan University from January 2012 to December 2014.Results：A total of 2 178 patients with polyps were enrolled（the detection rate is 7.5%）,including 833（38.2%）males and 1 345（61.8%）females,aged between 14 to 95,the high-risk age is 40 to 70years old（76.3%,1 662/2 178）,1 372cases（63.0%）were single polyp,806 cases were multiple polyps（37.0%）.Polyps were located mainly in the body and fundus of the stomach（71.5%）,a total of 1 761cases（79.9%,1 741/2 178）had the diameter of≤0.5cm;Among the 2 178 cases undergone pathologic examination,1 231 cases were inflammatory hyperplastic polyps（56.5%,1 231/2 178）,followed by the fundic gland polyps（903,41.5%）.A total of 1 973cases（90.6%）were Yamada typeⅠand typeⅡ.Conclusion：The detection rate of Gastric polyps is increasing year by year and changes in pathological spectrum are found as：the decreasing proportion of inflammatory hyperplastic polyps and increasing rate of thefundic gland polyps.Cardiac polyps are easily misdiagnosed and malignant transformation rate is high,so endoscopic physicians should strengthen the observation and follow-up of cardiac disease.