对146例胃粘膜活检诊断为“增生和异型增生”的病理学探讨

本文对病理诊断为增生或异型增生与癌之间有争议的１４６例胃粘膜活检进行研究。争议在于全部病例按Ｎａｇａｙｏ，ＭＩｎｇ等作者标准诊断为增生或异型曾生，如按作者修订的新标准应诊断为胃癌。上述所有病例作近期胃切除病检。结果２９例为早期胃癌，１１７例属中晚期胃癌。本文指出胞浆少、多形核、细胞排列失去极向，细胞有异型的腺管大小不一，排列不规则、半个腺管或腺管部分残缺、异型分支、异型芽生、共壁、网状结构，１－２

A Pathological Study on 146 Biopsies of Gastric Mucosa Diagnosed as Hyperplasia and Dysplasia

This paper is a pathological study in which collected 146 debatable biopsies of gastric mucosa that had been diagnosed as hyperplasia, dysplasia and carcinoma microscopically. All these cases were diagnosed as hypcrplasia and dysplasia according to the Nagayo's and Ming's standards. According to the author's revised standard, all these cases should be diagnosed as gastric carcinoma. Gastrectomy were performed recently on the above cases and the pathological diagnosis were 29 gastric carcinoma in early stage, the other 117 were in middle or late. This paper indicated that a little cytoplasm, multiform nucleus, the ceils arrangment loss of polarity, vary sized atypical glandular tubules, irregular arrangment, incompleteness appeared in half or partial gland, dysplasia epithelia budding and brandling, common wall of glands, network structure, cysts formed by one or two or more dysplasia epithelia, the nucleus squeeze to side single cell in cyst wall, variant newborn dysplasia glands etc., all of these manifestation are the Iession of carcinoma. The dysplasia should only be limited to the epithelia or glands with complete base, membrane. The dysplasia epithelia and glandular structure which located in intestitial substance are considered to be infiltrate carcinoma other than dysplasia.