胃增生性息肉伴癌变的临床病理特征分析

Clinical and pathological characteristics of gastric hyperplastic polyps coexisting with gastric cancers

目的:探讨胃增生性息肉(gastric hyperplastic polyps,GHP)伴癌变的临床、内镜和病理特点。方法:对18例病理确诊为GHP伴癌变患者的临床表现、内镜特征、病理特点、治疗情况进行回顾性分析。结果:18例GHP伴癌变患者年龄(67.2±7.8)岁(45~79岁),男6例、女12例;临床症状表现为腹痛、腹胀或无明显症状。患者合并胃内多发息肉为主(13例),单发的癌变GHP好发部位在胃体(7例)。内镜下病灶形态多样,15例为带蒂息肉,癌变息肉直径均>10 mm,9例直径>20 mm。背景黏膜中14例存在萎缩性胃炎,4例合并幽门螺杆菌(Helicobacter pylori,HP)感染。结论:GHP伴癌变患者缺乏特异性症状,对于HP阴性合并萎缩性胃炎的多发性胃息肉患者,需警惕较大、带蒂息肉癌变的可能。

Objective To investigate the clinical,endoscopic and pathologic characteristics of gastric hyperplastic polyps coexisting with gastric cancers.Methods A retrospective study was performed involving 18 patients who were pathologically confirmed with gastric hyperplastic polyps coexisting with gastric cancers.The clinical features,endoscopic findings,pathological characteristics and treatment strategy were analyzed.Results The age of 18 patients was 67.2±7.8 years(ranged 45-79),including 6 males and 12 females.The symptoms included abdominal pain,distention,and some patients were asymptomatic.Multiple polyps(13/18)were common.Single lesions were often located in the gastric corpus(7/18).Endoscopy showed various morphological changes.Pedunculated polyp was the most common type(15/18).All polyps were larger than 10 mm in diameter,and the polyps in 9 patients were larger than 20 mm.Fourteen patients had atrophic gastritis in the background mucosa,and 4 patients had Helicobacter pylori(HP)infection.Conclusion Gastric hyperplastic polyps coexisting with gastric cancers shows no specific symptoms.For HP(-)atrophic gastritis patients accompanied with multiple gastric polyps,malignant transformation of those larger and pedunculated polyps is of possibility.