胃上皮异型增生诊断及治疗研究进展

Advances in the Diagnosis and Treatment of Gastric Epithelial Dysplasia

胃上皮异型增生是重要的癌前病变,可通过病理检查进行诊断。为统一活组织检查标本的病理诊断标准,国际上提出Padova分类、Vienna分类、世界卫生组织(WHO)分类。目前,胃上皮轻度异型增生的自然病程仍有争议,胃上皮重度异型增生的癌变率高,而内镜活组织检查病理诊断与内镜切除标本病理诊断存在一定差异。本文对胃上皮异型增生的定义、自然病程、内镜诊断、治疗进行综述,提出对胃上皮异型增生患者行内镜下治疗或规律随访对预防早期胃癌具有重要意义。

Gastric epithelial dysplasia is an important precancerous lesion of gastric cancer,which is diagnosed by pathological examination.To standardize the classification and diagnosis of precancerous lesions in the world,Padova,Vienna,and WHO classifications were established.The natural history of low grade gastric dysplasia is still controversial,but the high grade gastric dysplasia is associated with high risk of malignant transformation of gastric cancer.Furthermore,there are histologic discrepancies between the results of endoscopic biopsy and endoscopic resection in the diagnosis of gastric epithelial dysplasia.This article reviews the definition,natural history,diagnosis and treatment of gastric epithelial dysplasia,and puts forward that endoscopic treatment of gastric epithelial dysplasia or regular follow-up is the most reliable strategy for the prevention of early gastric cancer.