放大内镜窄带成像下胃小凹形态及其临床病理意义

文章编号:1007-1989(2009)05-0466-03

·论著·

放大内镜窄带成像下胃小凹形态及其临床病理意义

李易,韩盛玺,刘晓岗

(四川省人民医院消化内科,四川成都610072)

摘要:目的探讨放大内镜窄带成像下胃小凹的形态分类及其临床病理意义。方法应用放大内镜窄带成

像术对164例因消化不良症状就诊患者进行检查,通过分析内镜观察到胃黏膜结构的改变,制定出A 型(圆点

状)、B (线状)、C 型(稀疏粗大的线状)、D 型(斑块状)和E 型(绒毛状)5型胃小凹形态分类,并与相应328

个病变组织的病理组织学改变进行比较分析。结果A 、B 、C 、D 和E 共5型分别见于从正常到重度萎缩、重度

肠上皮化生,并与慢性炎症及肠上皮化生的程度呈明显正相关,异型增生主要见于D 型和E 型胃黏膜。结论

5种基本胃小凹形态与病理组织学改变存在密切关系,通过放大内镜窄带成像准确识别5种胃小凹形态将有

助于对萎缩、肠上皮化生及异型增生等常见胃黏膜病变的诊断。

关键词:放大内镜;窄带成像;胃小凹;病理

中图分类号:

R 573.3文献标识码:A Magnifying endoscopy with narrow band imaging for gastric

pits classification and their clinicopathological significance

LI Yi, HAN Sheng-xi, LIU Xiao-gang

(Departmentof Gastroenterology, Sichuan Provincial People ′s Hospital, Chengdu, Sichuan 610072,

P.R.China)

Abstract:【Objective 】To explore the classification of gastric pits under magnifying endoscopy with narrow band

imaging and their clinicopathological significance. 【

Methods 】A total of 164patients with dyspepsia were examined by magnifying endoscopy with narrow band imaging. After analyzing the microstructure of gastric mucosa, the mor -phology of gastric pits was classified as follows:type A (roundspot pits), type B (linear),type C (sparselyand thickly

linear), type D (patchy)and type E (villous),which were compared to the histopathological findings of 328biopsies

from gastric mucosa. 【Results 】Types A, B, C, D and E were respectively found from normal gastric mucosa to mu -

cosa with sever atrophy and intestinal metaplasia, and the positive correlation was found between types A, B, C, D, E

and the degree of chronic gastritis or intestinal metaplasia. Dysplasia was mostly found in gastric mucosa of type D

and type E. 【

Conclusions 】Five types of gastric pits were closely related to histopathologic findings, and the identi -fication of gastric pits though magnifying endoscopy with narrow band imaging would help in the diagnosis of the

common gastric mucosal lesions including atrophy, intestinal metaplasia and dysplasia.

Key words:magnifying endoscopy; narrow band imaging; gastric pit; pathology

收稿日期:2008-12-30长期以来,人们一直在探索内镜直视下准确诊

断慢性胃炎的可能性,尤其是肠上皮化生及腺体萎

缩等病变的诊断,放大内镜和窄带成像等新技术的

出现,使这个愿望的实现带来了可能性。为此,我们

使用放大内镜窄带成像术对胃小凹形态分类及其临

床病理意义探讨如下。

1资料和方法1.1研究对象2008年8月~10月,因上腹不适、上腹痛、上腹胀、嗳气和反酸等消化不良症状在我院就医并进行放大胃镜窄带成像检查的胃炎患者,共164例。其中,男91例,女73例,年龄20~83岁,平均(51.8±

第15卷第5期

中国内镜杂志Vol. 15No. 5

2009年5月China Journal of Endoscopy May 2009

466··

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