胃粘膜肠上皮化生的意义探讨(摘要)

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在胃粘膜活组织检查中常常发现有肠上皮化生现象,尤其是萎缩性胃炎,肠化是很普遍的,那么肠化是否作为萎缩性胃炎病理表现的一部分,它与萎缩性胃炎的严重性及癌变有什么关系?为此我们收集近5年来经胃镜和病理检查确诊的萎缩性胃炎蜡块标本共202个(萎缩组),根据腺体萎缩程度分轻、中、重3组,各组标本分别103、78和21个。将蜡块重新切片,用常规染色和AB/PAS粘液组织化学染色后,由专人读片,采用全国病理学诊断统一标准,作出肠化程度(轻、中、重)和肠化类型(Ⅰ型、Ⅱ_a型、Ⅲ_b型)的诊断。同时收集胃癌标本蜡块109个(早期癌28个,进展期癌81个)和大致正常胃粘膜或浅表性胃炎标本蜡块103个,作为胃癌组和非萎缩组,处理与萎缩组标本相同。并与萎缩组作对照研究。比较各组肠化检出率,并以肠化程度轻、中、重半定量积分为1、2、3分,肠化类型Ⅰ、Ⅱ_a、Ⅲ_b型半定量积分为1、2、3分,作出肠化与非萎缩组,肠化与萎缩轻、中、重度3组,肠化与胃癌组的多因素相关分析(Fishe’分析),得出肠化程度与肠化类型与各病变状态的相关系数。 结果萎缩组肠化检出率最高,且随着萎缩程度加 Intestinal metaplasia is often found in gastric mucosal biopsy, especially atrophic gastritis, intestinal metaplasia is very common, then intestinal metaplasia as part of the pathological manifestations of atrophic gastritis, which is associated with the severity of atrophic gastritis And the relationship between canceration? To this end, we collected 202 pieces of atrophic gastritis specimens (atrophic group) diagnosed by gastroscope and pathological examination in the recent 5 years. According to the degree of glandular atrophy, The specimens were 103, 78 and 21 respectively. The paraffin sections were rescored and stained with conventional staining and AB / PAS mucin histochemical staining. The specimens were read by specialists and the national standard of pathological diagnosis was used to make the degree of intestinal metaplasia (light, medium and heavy) and type of intestinal metaplasia (type Ⅰ , Ⅱ_a type, Ⅲ_b type) diagnosis. At the same time, 109 pieces of wax samples (28 early carcinomas and 81 advanced carcinomas) and 103 paraffin blocks of normal gastric mucosa or superficial gastritis specimens were collected simultaneously. As gastric cancer group and non-atrophic group, the specimens were treated as same as the atrophic group . And contrasted with atrophy group. The detection rate of intestinal metaplasia in each group was compared, and the semi-quantitative integrals of light, medium and heavy were 1, 2 and 3 points respectively. The semi-quantitative integrals of intestinal type Ⅰ, Ⅱ_a and Ⅲ_b were 1,2,3, Multivariate analysis (Fishe ’analysis) of intestinal metaplasia and non-atrophic group, intestinal metaplasia and atrophy of mild, moderate and severe group, intestinal metaplasia and gastric cancer group was made, and the relationship between intestinal metaplasia and intestinal metaplasia Correlation coefficient. Results The rate of intestinal metaplasia in the atrophic group was the highest, with the degree of atrophy plus
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