摘要
目的:探讨放大色素内镜在胃黏膜癌前病变诊断中的应用价值.方法:应用电子放大内镜,结合美蓝染色,对180例患者的胃黏膜糜烂灶进行细微结构形态学观察,将胃黏膜小凹的形态分为:A型(圆点状)、B型(短小棒状)、C型(稀疏而粗大的线状)、D型(斑块状)、E型(绒毛状)和F型(小凹结构模糊不清、消失或伴异常增生毛细血管)6型,并与观察部位活检所得的病理组织学改变进行比较分析.结果:A,B型胃小凹主要见于正常胃黏膜,而C,D,E和F型分别见于活动性、萎缩性炎症和肠上皮化生及轻、重度异型增生的胃黏膜.E型黏膜约81.8%(99/121)为肠上皮化生.F型黏膜常提示病灶已出现不同程度的异型增生86.3%(69/80),F型黏膜伴异常增生毛细血管,89.9%出现异型增生.结论:放大色素内镜能准确识别胃小凹的形态,尤其是准确识别E和F型,有助于对肠上皮化生及异型增生等胃黏膜癌前病变的镜下诊断.
AIM： To evaluate diagnostic value of magnifying chromoendoscopy （MCE） in gastric premalignant lesions. METHODS： Microstructures of gastric mucosa in 180 patients with gastric erosion were examined using magnifying endoscopy in combination with methylene blue staining. Magnifying endoscopic patterns of gastric erosion pits were classified into six types： type A （round spot pits）, types B （short rod pits）, type C （sparsely and thickly linear）, type D （patchy）, type E （villous） and type F （unclear or disappearances of pits or abnormal hyperplasia blood capillary）. And the results of histopathological biopsy taken from gastric erosion were regarded as the gold standard. RESULTS： Types A and type B were found in normal gastric mucosa, while types C, D, E, F were found in gastric mucosa with active inflammation, atrophic inflammation, intestinal metaplasia and dysplasia of variable degree respectively. Type E mucosa （81.8%） suggested intestinal metaplasia, type F indicated existence of dysplasia of variable degree （86.3%）, and type F with abnormal hyperplasia blood capillary suggested dysplasia （89.9%）. CONCLUSION： Types of gastric pits could be accurately and effectively identified under magnifying chromoendoscopy and identification of type E and F would facilitate the diagnosis of such gastric premalignant lesions as intestinal metaplasia and dysplasia.
出处
《世界华人消化杂志》
CAS
北大核心
2008年第18期2052-2055,共4页
World Chinese Journal of Digestology
关键词
放大色素内镜
胃黏膜癌前病变
病理
Magnifying chromoendoscopy
Gastric premalignant lesions
Pathology
