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血清中幽门螺杆菌热休克蛋白抗体与胃炎性病变的相关性研究 总被引:1,自引:0,他引:1
目的 对血清中幽门螺杆菌 (Hp)热休克蛋白 (HSP)B抗体 (IgG)的滴度与胃黏膜病理变化之间的关系进行研究 ,以探讨HSPB抗体在Hp相关性疾病中的作用。 方法 从山东胃癌高发区随机取样 10 36例 ,其中Hp阳性者 6 0 0例 ,选取 30 0例行Hp三联根治治疗。第 5年复查胃镜并留血标本 ,随机抽取诊断为Hp阴性慢性浅表性胃炎 ,Hp阳性慢性浅表性胃炎、慢性萎缩性胃炎、消化性溃疡各 2 0例 ,用Westernblot法对患者血中Hp的HSPB抗体滴度进行比较。 结果 Hp阳性慢性浅表性胃炎患者的抗体滴度 (0 .5 0 5± 0 .0 6 1)高于Hp阳性萎缩性胃炎 (0 .4 4 8± 0 .10 5 ,P <0 .0 5 )及消化性溃疡(0 .4 4 7± 0 .10 9,P <0 .0 5 ) ,Hp阴性慢性浅表性胃炎的HSP抗体滴度最低。结论 血清中的HpHSPB抗体对于胃黏膜炎症的加重可能具有一定的保护作用 相似文献
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目的 观察全身热应激预处理对大鼠肠缺血—再灌注损伤(IR)程度的影响及其机制.方法 50只SD大鼠随机分为5组,各10只.A组为正常体温+假手术对照组,B组为正常体温+肠IR组;C组为38.5~39℃热应激+肠IR组,D组为40 ~40.5℃热应激+肠IR组,E组为41.5 ~42℃热应激+肠IR组.自然恢复血液灌注后60 min,取大鼠肠组织行形态学观察,取肠黏膜组织用Western blot法检测肠黏膜热休克蛋白(HSP) 72表达,用原位末端缺口标记法(TUNEL)检测大鼠肠黏膜上皮细胞凋亡情况,用比色法检测肠黏膜Caspase-3活性.结果 光镜下观察B组见有固有层破坏,出血;C组损伤程度比B组轻,见部分绒毛顶端破损;D、E组肠黏膜损伤程度更轻,仅出现绒毛顶端上皮下间隙增大或绒毛轻度水肿.肠黏膜HSP72水平A、B、C、D、E组分别为0.40±0.09、0.26 ±0.09、1.08±0.11、1.39±0.23、2.72±0.88.C、D、E组肠黏膜组织HSP72蛋白水平明显高于A、B组(P均<0.05);E组肠黏膜组织HSP72蛋白水平明显高于C、D组(P均<0.05).A、B、C、D、E组大鼠肠黏膜组织细胞凋亡率分别为4.60%±1.12%、35.53%±3.40%、21.10%±3.11%、7.50%±1.88%、6.60%±1.83%.肠黏膜细胞凋亡率D、E组比B组降低(P均<0.05).A、B、C、D、E组大鼠肠黏膜组织Caspase-3活性分别为1.22±0.14、2.72±0.55、1.33±0.24、1.41±0.30、1.16±0.30,C、D、E组大鼠肠黏膜组织Caspase-3活性与B组相比明显降低(P均<0.05).结论 全身热应激预处理对肠IR有保护作用,以40、42℃热应激预处理保护作用较强,其机制与HSP72的表达水平有关. 相似文献
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艾灸预处理对应激性溃疡大鼠胃黏膜HSP70蛋白及mRNA表达的影响 总被引:4,自引:2,他引:4
目的:观察艾灸足三里和梁门穴预处理对应激性溃疡大鼠胃黏膜热休克蛋白70(HSP70)及其基因表达的影响,探讨艾灸足阳明经穴保护胃黏膜的作用机制.方法:将60只大鼠完全随机分为空白组(A)、模型组(B)、艾灸足三里等穴组(C)和对照组(D)4组,采用水浸-束缚应激法(WRS)制备应激性溃疡模型.按Guth法计算胃黏膜损伤指数(UI),用免疫组织化学法、逆转录聚合酶链式反应(RT-PCR)法和放射免疫法分别检测处理后大鼠胃黏膜HSP70,HSP70mRNA的表达和内皮素(ET)、前列腺素E2(PGE2)的含量.结果:SU大鼠胃黏膜损伤指数B组与A、C组(P=0.000,P=0.001),D组与A、C组(P=0.001)有显著性差异,艾灸足三里等穴可使SU大鼠胃黏膜损伤指数明显下降.胃黏膜PGE2含量A组与B、D组比较差异显著(P=0.011,P=0.028),C组与B、D组比较差异显著(P=0.020,P=0.048),经艾灸预处理的大鼠胃黏膜PGE2含量均有不同程度升高.ET含量B组与A组之间有显著差异(P=0.040),经艾灸预处理的大鼠ET含量下降显著,B组与C组相比差异显著(P=0.020).造模后胃黏膜的HSP70蛋白和mRNA表达均有不同程度的增强,B组与A组相比有显著性差异(P=0.039,P=0.008);经艾灸预处理后HSP70蛋白和mRNA显著增强,C组与B、D组比较有统计学意义(蛋白:P=0.003,P=0.035;mRNA:P=0.000,P=0.001).结论:艾灸足三里、梁门穴能通过增强HSP70的蛋白和基因表达,达到对胃黏膜的保护作用,并有一定的穴位特异性. 相似文献
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动态观察特异性血清IgG,IgA对幽门螺杆菌的诊断和疗效的意义 总被引:10,自引:0,他引:10
动态观察特异性血清IgG、IgA对幽门螺杆菌的诊断和疗效的意义王虹,杨建华,屠柏强,汪明,肖正达,郭映明,付志君,孙振兴,张兴荣,张宗祁,姚光弼本研究通过血清特异性抗Hp-IgG、IgA测定的动态观察,及其与病理切片和快速尿素酶试验二种诊断方法的比较... 相似文献
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目的探讨胃粘膜中热休克蛋白72(HSP72)、幽门螺杆菌(Hp)的热休克蛋白60(又称HSPB)在Hp感染中的病理生理意义。方法用免疫组织化学方法和Westernblotting法检测Hp(+)组和Hp(-)组的十二指肠球部溃疡患者胃窦粘膜中HSP72、HSPB的表达情况。结果Hp(+)组HSP72的表达明显高于Hp(—)组(P<0.05),Hp(+)组HSPB的表达显著高于Hp(—)组(P<0.01)。结论Hp自身可表达HSPB作为其致病因子;Hp又可诱导胃粘膜表达HSP72介导胃粘膜的细胞保护机制。 相似文献
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[目的]探讨隆起糜烂性胃炎(Raised Erosive Gastritis,REG)中医证型与幽门螺杆菌(Hp)感染和病理组织学及热休克蛋白60(HSP60)、热休克蛋白70(HSP70)表达的关系,以期指导中西医结合防治REG。[方法]选择131例REG患者按中医辨证分为脾胃湿热证32例(Hp阳性19例,阴性13例),脾胃气虚证52例(Hp阳性者34例,阴性18例),脾虚湿热证47例(Hp阳性者33例,阴性14例)。所有受试者均行胃镜检查,取胃窦部活检标本行快速尿素酶试验及组织染色法检测Hp;病理组织学检查及免疫组织化学检测HSP60,其中63例免疫组织化学检测HSP70。并设正常对照(正常)组18例。[结果]REG脾虚湿热证组的萎缩、肠化生(IM)程度均高于脾胃湿热证及脾胃气虚证组(P0.05),而后2组之间比较以及3组中Hp阳性者与阴性者比较差异均无统计学意义(P0.05)。3组HSP60表达均较正常组增加(P0.01),而3组之间比较均P0.05;脾胃湿热证及脾虚湿热证组中Hp阳性者的HSP60表达均高于Hp阴性者(P0.05),而脾胃气虚组中的Hp阳性与Hp阴性者比较P0.05。3组的HSP70表达均较正常组增加(P0.01);而3组的HSP70阳性表达情况分别比较均P0.05;脾胃湿热证组中Hp阴性的HSP70表达高于Hp阳性者(P0.05),而脾胃气虚证组与脾虚湿热证组中Hp阳性者与阴性者HSP70表达比较均P0.05。REG Hp阳性者胃黏膜HSP60的表达明显高于Hp阴性(P0.01);REG Hp阳性者胃黏膜HSP70的表达与Hp阴性者比较P0.05。[结论]REG脾虚湿热证患者胃黏膜萎缩、IM程度均高于脾胃气虚证及脾胃湿热证。REG3组胃黏膜HSP60及HSP70的表达均较正常组增强。Hp感染可诱导胃黏膜HSP60的高表达。HSP60表达既与Hp感染有关,又与湿热之邪有关。 相似文献
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血清胃蛋白酶原、胃泌素-17和幽门螺杆菌IgG抗体筛查萎缩性胃炎和胃癌 总被引:16,自引:5,他引:16
背景:目前萎缩性胃炎和胃癌仍需经过胃镜活检组织病理学检查才可确诊。许多研究显示,血清胃蛋白酶原(PG)Ⅰ、PGⅡ、胃泌素-17(G-17)和幽门螺杆菌(Hpylori)IgG抗体可用于筛查慢性萎缩性胃炎和胃癌。目的:评价能否以血清PGI、PGI/PGⅡ比值(PGR)、G-17和H.pytori-IgG抗体检测筛查萎缩性胃炎,并提高胃癌的早期诊断率。方法:胃癌高发区上海经胃镜检查确诊的458例胃十二指肠疾病患者纳入研究。血清学检查前在胃镜下取多处活检,根据组织病理学检查结果将受检者分为5组:正常对照组(包括轻度非萎缩性胃炎)77例,萎缩性胃炎组92例,胃癌组141例,胃溃疡组58例,十二指肠球部溃疡组90例。以酶联免疫吸附测定(EuSA)定量检测受检者空腹血清PGI、PGII和G-17水平。定性分析血清H.pylori—IgG抗体。结果:萎缩性胃炎组和胃癌组的PGI和PGR水平显著降低(P〈0.01);根据接受者操作特征(ROC)曲线,两者诊断萎缩性胃炎的最佳界值分别为82.30μg/L(敏感性85.9%,特异性75.1%)和6.05(敏感性78.3%,特异性71.6%)。萎缩性胃炎组的PGI、PGR和G-17水平与萎缩部位和(或)程度显著相关(P〈0.01),萎缩性胃体胃炎PGI和PGR水平降低,G-17水平明显升高,萎缩性胃窦胃炎G-17水平降低。胃癌组G-17水平显著升高(P〈0.01),进展期胃癌的PGI和PGR水平较早期胃癌显著降低(P〈0.01),但两者D-17水平差异不明显。正常对照组H.pylori-IgG抗体阳性率为54.5%,阳性者的PGI水平显著高于阴性者(P〈0.01),但两者G-17水平差异不明显。其余4组的H.pylori—IgG抗体阳性率均大于85%。结论:血清PGI、PGR和G.17水平低下分别是胃体和胃窦萎缩的生物学标志,可根据血清PGI和PGR界值进行萎缩性胃炎的筛查。结合血清G-17水平明显升高而PGI、PGR水平明显降低可进行胃癌筛查。H.pylon感染与PG水平的变化有关。 相似文献
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艾灸足三里和梁门穴诱导热休克蛋白70抗大鼠胃黏膜氧化损伤作用 总被引:15,自引:0,他引:15
目的:观察艾灸足三里和梁门穴对应激性溃疡大鼠胃黏膜热休克蛋白70(HSP70)表达的影响,探讨艾灸足阳明经穴抗胃黏膜氧化损伤的作用机制.方法:将SD大鼠60只完全随机平均分为空白组、模型组、艾灸足三里等穴组和艾灸非穴对照点组,采用水浸-束缚应激法制备应激性溃疡模型.按Guth法计算胃黏膜损伤指数(UI),用激光多普勒血流仪测定胃黏膜血流量(GMBF),用免疫组织化学法和硫代巴比妥酸染色法对处理后大鼠检测其胃黏膜HSP70的表达和丙二醛(MDA)的含量.结果:与模型组和艾灸非穴组比较,艾灸足三里等穴可使应激性溃疡大鼠胃黏膜损伤指数明显下降(14.100±5.425vs26.800±9.807,26.200±7.729,P<0.01),HSP70表达上调(0.133±0.035vs0.077±0.057,0.059±0.038,P<0.01)、血流量增高(279.827±172.862mL/minvs139.489±33.133,141.512±58.450mL/min,P<0.05)、MDA含量减少(2.586±0.252μmol/Lvs3.906±0.768,3.464±1.502μmol/L,P<0.05).结论:艾灸足三里和梁门穴能诱导胃黏膜HSP70高表达并降低MDA含量,以达到其抗氧化损伤作用,并有相对的穴位特异性. 相似文献
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[目的]观察以胃舒散为主的三联疗法(胃舒散、呋喃唑酮和克拉霉素)治疗幽门螺杆菌(Hp)阳性慢性萎缩性胃炎(CAG)的临床效果及其对核因子-κB(NF-κB)表达的影响。[方法]41例Hp阳性CAG患者服用胃舒散2.0g,呋喃唑酮0.1g,各3次/d,克拉霉素0.25g,2次/d,1周后再继服胃舒散4周。治疗前及治疗结束1年后行内镜及病理组织学检查,取活检观察病理组织学改变及NF-κB表达变化,采用银染色法、^14C-尿素呼气试验或快速尿素酶试验检测Hp。[结果]三联疗法结束1年后,Hp根除率为85.4%;根除Hp能显著减轻患者胃窦部慢性炎症(P〈0.05)和活动程度(P〈0.01),下调NF-κB表达(P〈0.01),但胃炎的萎缩和肠化生等病理无明显改变。[结论]以胃舒散为主的三联疗法对Hp有较高根除率。根除Hp可抑制NF-κB的表达,减轻活动性炎症,但近期观察对萎缩、肠化生等病理改变无明显作用。 相似文献
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AIM: To demonstrate the effect of Hewei-Decoction (Decoction for regulating the stomach) on chronic atrophic gastritis (CAG) and eradication of Helicobacter pylori. METHODS: Ninety patients with CAG entering the investigation were divided into six differentiation syndromes, based on their major symptoms and signs. Hewei-Decoction was taken by all the patients orally for 4 or 8 wk. The efficacy was assessed by both the composite accumulation of reduced scores of major symptoms and the eradication of H pylori.X2 test was used to compare the efficacy between H pylori-positive and negative cases, and to disclose the relationship between efficacy and eradication of H pylori. RESULTS: In patients with six different syndrome types, the efficacy of Hewei-Decoction was 91.67% (11/12), 92.86% (13/14), 97.22% (35/36), 87.50% (14/16), 75.00% (6/8), 75.00% (3/4) respectively. The rate of highly efficacious was 58.33% (7/12), 50.00% (7/14), 77.78% (28/36), 62.50% (10/16), 12.50% (1/8) and 25.00% (1/4), respectively. The total efficacy was 91.11% (82/90), and the rate of highly efficacious was 60.00% (54/90). The eradication rate of H pylori was 67.86% (38/56). The therapeutic effect of Hewei-Decoction was better in H pylori positive cases than that in H pylori-negative cases with the total effect of 96.43% vs 82.35% (P<0.05). In 56 H pylori positive cases, the therapeutic effect was better in H pylori eradicated cases than that in H pylori-existent cases with the total effect of 97.37% vs 72.22% (P<0.01). CONCLUSION: Hewei-Decoction is effective in most cases of all the syndrome types. The results indicate that eradication of H pylori is one of the important mechanisms for alleviation of symptoms and signs. Also, the decoction is efficacious in H pylori-negative cases. 相似文献
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Association of Helicobacter pylori infection with atrophic gastritis and intestinal metaplasia 总被引:8,自引:0,他引:8
Ohkuma K Okada M Murayama H Seo M Maeda K Kanda M Okabe N 《Journal of gastroenterology and hepatology》2000,15(10):1105-1112
AIMS: To evaluate the effect of Helicobacter pylori infection and aging on atrophy and intestinal metaplasia of the gastric mucosa. METHODS: One hundred and sixty-three patients were divided into three age groups and underwent an upper gastrointestinal endoscopy where no esophagitis, peptic ulcers, or malignancies were detected. Two biopsy specimens were obtained from the anterior and posterior walls of the antrum and of the fundus. These were used to evaluate the grade of gastritis, bacterial culture and histologic evidence of H. pylori infection. RESULTS: Helicobacter pylori infection was found to be directly associated with an increased risk of gastritis grade (odds ratio (OR) = 90 (95% CI; 30-270)). An age of 60 years and older along with H. pylori infection was also strongly associated with an increased risk of atrophy (OR = 6.6, (95% CI; 2.9-15.2)); OR = 9.8, (95% CI; 2.7-35.4)), as was intestinal metaplasia of the gastric mucosa (OR = 5.5, (95% CI; 1.7-17.6)); OR = 7.9, (95% CI; 2.8-46.1)). The prevalence of atrophic gastritis increased with advancing age in H. pylori-infected patients, but no such phenomenon was observed in H. pylori-uninfected patients. The prevalence of intestinal metaplasia significantly increased with advancing age, irrespective of the presence of H. pylori infection. In addition, H. pylori uninfected female patients had a decreased risk of intestinal metaplasia. CONCLUSIONS: These results suggest that atrophic gastritis is not a normal aging process, but instead is likely to be the result of H. pylori infection, while intestinal metaplasia is caused by both the aging process and H. pylori infection. A decreased risk of intestinal metaplasia found in uninfected female subjects may partly explain the lower prevalence of gastric cancer in females than in males. 相似文献
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目的通过对幽门螺杆菌(Hp)相关的萎缩性胃炎病人Hp清除治疗前后胃窦部黏膜病理改变的分析,来确定Hp对其炎症程度、活动性(中性粒细胞浸润)、腺体萎缩和肠上皮化生的影响。方法106例Hp相关的萎缩性胃炎患者接受Hp清除治疗,对其治疗前后胃窦部黏膜的病理变化进行分析,分析标准按96悉尼系统评定。结果在62例治疗成功组中,治疗后胃黏膜的炎症程度及活动性较治疗前明显减轻,但腺体萎缩及肠上皮化生未减轻。在44例治疗失败组中,治疗前后胃黏膜的炎症程度、活动性、腺体萎缩及肠化均没有变化。且随着Hp感染时间的延长,腺体萎缩和肠化还可加重。结论Hp的清除治疗可使萎缩性胃炎患者胃黏膜的炎症程度及活动度减轻,对此类病人应行Hp清除治疗。 相似文献
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慢性胃炎结节状改变与幽门螺杆菌感染的关系研究 总被引:4,自引:3,他引:4
目的 探讨慢性胃炎结节状改变与幽门螺杆菌 (Hp)感染的关系。方法 对 2 0 0 1~2 0 0 2年中胃镜检查发现的慢性胃炎结节状改变患者进行Hp检测 ,对Hp阳性患者 ,进行Hp根除治疗 ,随访 6个月 ,观察其胃镜下的改变。结果 4 939例胃镜检查患者中共发现 1 3例慢性胃炎结节状改变 ,占检查总人数的 0 2 6 %。平均年龄 2 9岁 ,均为女性患者。主要症状均为上腹部疼痛。所有患者均有Hp感染。Hp根除成功后 ,症状和胃镜下结节状表现消失 ,病理证实胃黏膜下淋巴滤泡也随之消失。结论 慢性胃炎结节状改变可作为Hp阳性胃炎的内镜下的表现之一。 相似文献
17.
Tucci A Poli L Biasco G Paparo GF Tosetti C Fusaroli P Sambri V Donati M Grigioni W Labate AM Stanghellini V Caletti G 《Digestive diseases and sciences》2001,46(7):1573-1583
In the present study we evaluated the relation among histology, H. pylori, IgG to H. pylori, gastric emptying, and acid secretion in 43 patients with fundic atrophic gastritis. On the basis of gastric acid secretion, patients were divided into three subgroups: patients with preserved acid secretion (Group 1), patients with hypochlorhydria (Group 2), and patients with achlorhydria (Group 3). Fundic glandular atrophy was more severe in hypoachlorhydric patients than in those with preserved acid secretion (P < 0.05 vs Group 2, P < 0.005 vs Group 3). H. pylori colonization was found in 94% of patients in Group 1, in 61% of patients in Group 2, and in only 8% of patients in Group 3 (P < 0.001 vs Group 1, P < 0.05 vs Group 2). Conversely, serological positivity to H. pylori was high in all three subgroups of patients (100% in Group 1, 77% in Group 2, 92% in Group 3). Gastric emptying was delayed in atrophic patients, particularly in those with hypoachlorhydria. Our data suggest that fundic atrophic gastritis represents a possible end stage of H. pylori infection, characterized by a progressive disappearance of the bacterium and a progressive deterioration of gastric functions. 相似文献
18.
幽门螺杆菌的根除与萎缩性胃炎形成和逆转的动物实验研究 总被引:47,自引:2,他引:45
目的 明确根除幽门螺杆菌(Helicobacter pylori,Hp)对萎缩性胃炎的形成和逆转的影响。方法 110只2级C57BL/6小鼠随机分为实验组(60只)和对照组(50只)。实验组感染Hp后又随机分为A、B两组,并分别于感染后6个月和12个月根除Hp。采用番尼系统、免疫组化及流式细胞术比较根除前后鼠腺胃黏膜组织学和细胞动力学。结果 (1)接受根除治疗的动物Hp检查均为阴性。根除Hp可明显 相似文献
19.
A topographic study of Helicobacter pylori density, distribution and associated gastritis 总被引:2,自引:0,他引:2
Misra V Misra S Dwivedi M Singh UP Bhargava V Gupta SC 《Journal of gastroenterology and hepatology》2000,15(7):737-743
BACKGROUND AND AIMS: The topographic distribution and density of Helicobacter pylori and associated gastritis in the stomach were studied in order to determine which biopsy sites are likely to provide the maximum yield so as to reduce the fallacious results due to sampling error. METHODS: Fifty patients with upper gastrointestinal symptoms were studied. Eleven gastric biopsies from predetermined sites were obtained and subjected to ultra-rapid urease test, imprint cytology and histology. Haematoxylin and eosin stain was used for defining gastritis and other associated histopathological details. Loeffler's methylene blue stain was used to confirm the presence of H. pylori in imprint smears and histological sections. RESULTS: All 50 patients had H. pylori infection and evidence of chronic gastritis at one or more of the 11 biopsy sites. Maximum and minimum percentage positivity were observed at A3 (antral lesser curvature) and B4 (corpus greater curvature), respectively. Various sites in decreasing order of percentage positivity were A3 > A2 > A1 > A4 > B3 > B1 > A5 > B6 > B5 > B2 > B4. Among the biopsies obtained from the corpus, B3 (corpus lesser curvature) was the site with maximum positivity. A3 and B4 had a statistically significant difference in percentage positivity (P < 0.0001) for H. pylori and gastritis. The maximum and minimum density scores of H. pylori and gastritis were found in A3 and the B4, respectively. A3 had a significantly higher (P < 0.0001) mean density score than any other site in the stomach. The difference in the grading of H. pylori between A3 and B3 (sites of maximum positivity in antrum and corpus) was statistically significant (P < 0.0001). A statistically significant (P < 0.001) positive correlation between increasing grades of H. pylori and gastritis was observed at the site of maximum density. Eighty per cent of the patients had antral predominant gastritis and in 82%, H. pylori was predominantly observed in antral biopsies. CONCLUSION: It is concluded that two biopsies taken from A3 are sufficient for confirmation of presence of H. pylori and associated gastritis for initiation of treatment. However, additional biopsies from B3 will help in deciding the topographic pattern of gastritis. 相似文献
20.
Vincenzo Villanacci Giovanni Casella Francesco Lanzarotto Camillo Di Bella Angelo Sidoni Moris Cadei 《Scandinavian journal of gastroenterology》2017,52(6-7):674-677
Background: Autoimmune gastritis (AIG) is a gastric pathologic condition affecting the mucosa of the fundus and the body and eventually leading to hypo-achlorhydria.Aims: We report our clinical and pathological experience with AIG.Methods: Data from patients with a diagnosis of AIG seen in the period January 2002–December 2012 were retrieved. Only patients with complete sets of biopsies were analyzed.Results: Data from 138 patients were available for analysis. Pernicious anemia was present in 25% of patients, iron deficiency anemia was found in 29.7% of patients, hypothyroidism in 23% of patients, type 1 diabetes in 7.9% of patients, and vitiligo in 2.8% of patients. Parietal cell antibodies were positive in 65% of patients, and no patient had serology positive for celiac disease. All gastric biopsies showed glandular atrophy associated with enterochromaffin-like (ECL)-cells hyperplasia, features limited to the mucosa of the fundus and body, and focal glandular intestinal metaplasia. Helicobacter pylori was negative in all cases.Conclusions: AIG was strongly associated with anemia; atrophy, intestinal metaplasia and ECL hyperplasia in the gastric fundus and body are hallmarks of this condition. 相似文献