罕见的胃底腺型胃癌69例内镜特征分析

Rare gastric adenocarcinoma of fundic gland type:endoscopic features in 69 domestic cases

[目的]分析罕见的胃底腺型胃癌(GA-FG)内镜下特征,提高其诊治能力。[方法]在中国知网、万方医学、PubMed、Springer等数据库中检索相关文献,收集我国学者公开报道的GA-FG病例共68例(69处病灶),分别对“病变部位、大小、表面形态、色调、背景黏膜”等内镜下表现进行归纳,分析其内镜下主要形态特征。[结果]GA-FG好发于中老年,我国平均患病年龄59岁,无明显性别差异。98.6%病灶发生于胃中、上部,97.0%为单发病灶,96.0%无萎缩肠化背景黏膜,88.0%病灶小于1 cm,平均直径7.5 mm。79.7%病灶为隆起型,且以浅表隆起型(Ⅱa)占绝大多数。73.9%病灶表面有血管扩张。52.8%呈褪色调改变。[结论]发生于胃中上部、单个小于1 cm、无萎缩肠化背景黏膜、有表面血管扩张、呈褪色调改变的浅表隆起型病变是国内患者GA-FG内镜下主要形态特征。

[Objective]To analyze and summarize the endoscopic features of a rare subtype case of gastric cancer:gastric adenocarcinoma of fundic gland type(GA-FG)in domestic patients,and improve the diagnosis and treatment capacity of GA-FG.[Methods]A total of 68 GA-FG cases(69 lesions)reported by Chinese scholars were collected from the databases of CNKI,Wanfang Medicine,PubMed and Springer.The endoscopic manifestations of“location,size,surface morphology,color tone and background mucosa”were summarized respectively,and the main endoscopy features of GA-FG were analyzed and summarized.[Results]The GA-FG occurred in elderly patients with the average age of 59 years old.There was no significant gender difference.The lesion were located in the middle/upper third of the stomach(98.6%),single lesion(97.0%)and no atrophic and no intestinal metaplasia in surrounding mucosal background(96.0%).Lesions were less than 1 cm(88.0%),the average diameter was 7.5 mm.79.7%lesions were elevated type,and the majority type were IIa.Dilatational surface vascular and faded-whitish mucosa were 73.9%and 52.8%respectively.[Conclusion]The main endoscopy features of GA-FG are the superficial and elevated lesions that occurred in the middle/upper third of the stomach,single and less than 1 cm,no atrophic and no intestinal metaplasia in surrounding mucosal background,dilatational surface vascular and faded-whitish mucosa.