胃小弯癌的临床内镜研究

目的:探讨胃小弯癌的临床内镜病理特征。方法:应用临床流行病学方法,对50例胃小弯癌患者的首发症状、内镜表现、病理类型及幽门螺杆菌(Helicobacter pylori, Hp)进行研究及分析。结果:隆起溃疡型(60％)、溃疡型(26％)、隆起型(14％)的发生率依次降低;直径>2cm病灶的发生率(88％)显著高于直径<2cm病灶的发生率(12％);低分化腺癌(54％)、腺癌(30％)、印戒细胞癌(8％)、管状腺癌(2％)、黏液腺癌(2％)的发生率依次降低;Hp(-)的发生率(68％)显著高于Ep(+)的发生率(32％)。结论:胃小弯癌患者中隆起溃疡型发生率最高,多为低分化腺癌,直径>2cm病灶多见,较少受到Hp的感染。

Candida esophagitis:Risk factors in non-HIV population in Pakistan

AIM:Candida esophagitis is a frequent infection in immunocompromised patients. This study was designed to determine its characteristics in non- human immune deficiency virus (HIV) infected patients attending a teaching hospital.METHODS: Clinical records of all patients coded by international classification of diseases 9th revision with clinical modifications'(ICD-9-CM), with candida esophagitis diagnosed by esophagogastroduodenoscopy (EGD) and histopathology over a period of 5 years were studied.RESULTS: Fifty-one patients (27 males, 24 females, range 21-77 years old and mean age 52.9 years) fulfilled the criteria (0.34% of the EGD). The common predisposing factors were carcinoma (OR 3.87, CI 1.00-14.99) and diabetes mellitus (OR 4.39, CI 1.34-14.42). The frequent clinical symptoms were retrosternal discomfort, dysphagia and epigastric abdominal pain with endoscopic appearance of scattered mucosal plaques. Another endoscopic lesion was associated with candida esophagitis in 15% patients.CONCLUSION: Carcinomas, diabetes mellitus, corticosteroid and antibiotic therapy are major risk factors for candida esophagitis in Pakistan. It is an easily managed complication that responds to treatment with nystatin.