上消化道黏膜病变病理诊断结果分析

目的 探讨上消化道黏膜病变的病理类型和临床特点的关系，为临床诊治该病提供参考依据。方法 回顾性分析 2014 年1 月~2018 年 12 月我院收集的 9659 例上消化道黏膜活检病理诊断结果，观察胃炎、息肉、溃疡和肿瘤病变与年龄、性别、幽门螺杆菌（Hp）感染情况的关系。结果 ①胃炎:不同年龄段慢性炎症、萎缩、肠化、上皮内瘤变人数比较，差异有统计学意义（P<0.05）。女性慢性炎症轻度和中度人数高于男性，差异有统计学意义（P<0.05）；不同性别萎缩、肠化、上皮内瘤变人数比较，差异无统计学意义（P>0.05）；慢性炎症、萎缩、肠化、上皮内瘤变不同严重程度 Hp（+）人数高于 Hp（-），差异均有统计学意义（P<0.05）。②息肉；不同年龄段胃息肉、贲门息肉、食道息肉病变人数比较，差异有统计学意义（P<0.05)。女性胃息肉、食道息肉人数高于男性，差异有统计学意义（P<0.05）；不同性别贲门息肉、十二指肠息肉人数比较，差异无统计学意义（P>0.05）。胃息肉、贲门息肉不同类型 Hp（+）人数高于 Hp（-），差异有统计学意义（P<0.05）；食道息肉、十二指肠息肉 HP 感染人数比较，差异无统计学意义（P>0.05）。③溃疡和肿瘤病变:不同年龄段胃溃疡、胃癌、食管癌人数比较，差异有统计学意义（P<0.05）；不同年龄段贲门溃疡人数比较，差异无统计学意义（P>0.05）。男性胃溃疡、食道溃疡、贲门溃疡、胃癌、食管癌人数高于女性，差异有统计学意义（P<0.05）。胃溃疡、食道溃疡、贲门溃疡、胃癌、食管癌Hp（+）人数高于Hp（-），差异有统计学意义（P<0.05）。结论 轻度慢性胃炎好发于青中年性、息肉、溃疡、肿瘤病变好发于中老年人，轻度慢性胃炎、息肉病变好发于女性，溃疡和肿瘤病变好发于男性，胃炎相关病变、息肉、溃疡、肿瘤与 Hp 感染密切相关。

Analysis of Pathological Diagnosis for Upper Gastrointestinal Mucosal Lesions

Objective To explore the relationship between pathological types and clinical characteristics of upper gastrointestinal mucosal lesions, and to provide reference basis for clinical diagnosis and treatment of the disease. Methods A retrospective analysis of 9659 cases of upper gastrointestinal mucosal biopsy collected in our hospital from January 2014 to December 2018 was performed to observe the gastroenteritis, polyps, ulcers, tumor lesions, age, gender, and Helicobacter pylori (Hp) infection relationship. Results ①Gastritis:There were significant differences in the number of chronic inflammation, atrophy, intestinalization, and intraepithelial neoplasia at different ages( P<0.05). The number of women with mild and moderate chronic inflammation was higher than that of men,the difference was statistically significant( P<0.05); there was no significant difference in the number of atrophy, intestinalization, and intraepithelial neoplasia between different genders (P>0.05);Chronic inflammation, atrophy, intestinalization, and intraepithelial neoplasia were more severe in Hp (+) than Hp(-),the differences were statistically significant( P<0.05). ②Polyps:There were statistically significant differences in the number of lesions of gastric polyps, cardia polyps, and esophageal polyps at different ages( P<0.05). The number of women with gastric polyps and esophagus polyps was higher than that of men,the difference was statistically significant( P<0.05). There was no significant difference in the number of different genders of cardia polyps and duodenal polyps(P>0.05). The number of different types of Hp(+) in gastric polyps and cardia polyps was higher than Hp (-),the difference was statistically significant( P<0.05). There was no significant difference in HP infection among esophageal polyps and duodenal polyps( P>0.05). ③Ulcers and tumor lesions:There was a statistically significant difference in the number of gastric ulcers, gastric cancer, and esophageal cancer at different ages( P<0.05); there was no statistically significant difference in the number of cardiac ulcers at different ages( P>0.05). The number of gastric ulcer, esophageal ulcer, cardia ulcer, gastric cancer, and esophageal cancer was higher in men than in women,the difference was statistically significant( P<0.05). Gastric ulcer, esophageal ulcer, cardiac ulcer, gastric cancer, and esophageal cancer Hp (+) were higher than Hp (-), the difference was statistically significant(P<0.05). Conclusion Mild chronic gastritis is more common in young and middle-aged people, polyps, ulcers, and tumor lesions are more common in middle-aged and elderly people. Mild chronic gastritis and polyp lesions are more common in women, and ulcers and tumors are more common in men.Polyps, ulcers, tumors are closely related to Hp infection.