子宫内膜异位症145例临床病理分析

目的观察不同部位子宫内膜异位症的病理形态特征。方法对笔者所在医院及会诊的145例子宫内膜异位症的临床和病理资料进行复查与分析。结果子宫内膜异位症以41～50岁为发病高峰，占51．72％。我们收集资料中，最小者为20岁，最大者为63岁。其病变部位以子宫肌壁内为最多，占62．75％。笔者资料中还可见到有卵巢、输卵管、会阴、腹壁皮肤及盆腔淋巴结等部位。其病理特征，异位的子宫内膜大都显示正常之子宫内膜腺体和间质，形成较大囊肿者，其囊壁可见异物肉芽肿组织，含铁血黄素的巨噬细胞等。结论子宫内膜异位症是妇产科较为常见的多发病，也是病理科较常遇到的瘤样病变，诊断较易，主要是与转移性高分化腺癌进行区别。     

老年人Barrett食管的内镜表现及病理特征分析

Objective To explore the similarities and differences in endoscopic and pathological characteristics between elderly and non-elderly patients with Barrett esophagus (BE). Methods Three hundred and seventy-one cases with BE were divided into elderly group (n=254) and nonelderly group (n=117). The detection rate, endoscopic findings and pathological changes were assessed. Results The detection rate of BE was 2.9% in the elderly, and 0. 9% in the non-elderly(χ2 =127.8, P＜0.01). The 112 cases (44.1%) of the elderly had reflux symptoms, and so did 87cases (66.7%) of the non-elderly (χ2 =55.9, P＜0.01). The detection rate of BE in the two groups was increased year by year from 2004 to 2008. The detection rate of ring pattern was significantly higher in elderly group than in non-elderly group (28.7% vs. 10.3%, χ2=14.5, P＜0.01). Nonelderly patients had higher rate of island pattern than elderly patients (59.5% vs. 71.7%, χ2=4.7,P＜0.05). There were significant differences in the rate of specialized intestinal metaplasia between elderly and non-elderly patients (42.1% vs. 27.4%, χ2=6.9, P＜0.01). The difference in low and medium grade intraepithelial neoplasm between the two groups had statistical significance (21.3% vs.11.1%, χ2=4.9, P＜0.05). There were two cases with adenocarcinoma in elderly group, but no case was found in non-elderly group. The detection rate of H. pylori was comparable between elderly group and non-elderly group (35.5% vs. 40.9%, χ2=0.40, P＞0.05). Conclusions The elderly patients have the 3.2 times higher detection rate of BE than non-elderly patients. The detection rates of specialized intestinal metaplasia and intraepithelial neoplasm are higher in elderly group than in nonelderly group.     

老年人Barrett食管的内镜表现及病理特征分析

目的 探讨老年人与非老年人Barrett食管(Barrett's esophagus,BE)的内镜表现及病理特征.方法 将371例BE患者根据年龄分老年组(254例)和非老年组(117例),并对其内镜表现及病理特征进行对比分析.结果 老年组和非老年组BE检出率分别为2.9%和0.9%(χ2=127.8,P＜0.01).2004-2008年,老年组与非老年组BE检出率均呈逐年上升趋势.老年组中有典型反流症状者112例(44.1%),非老年组8718例(66.7%),差异有统计学意义(χ2=55.9,P＜0.01).老年组全周型BE所占比例较非老年组高,差异有统计学意义(28.7%对10.3%,χ2=14.5,P＜0.01),非老年组岛型所占比例较老年组高,差异有统计学意义(59.5%对71.7%,χ2=4.7,P＜0.05).老年组特异性肠化发生率(42.1%),较非老年组(27.4%)明显升高(χ2=6.9,P＜0.01).老年组中轻中度上皮内瘤变的发生率较非老年组高,差异有统计学意义(χ2=4.9,P＜0.05).老年组中有2例腺癌,而非老年组未检出腺癌.老年组食管下段Hp检出率为35.5%(65/183),非老年组为40.9%(27/66),两组比较差异无统计学意义(χ2=0.40,P＞0.05).结论 老年人BE检出率高于非老年人,老年BE患者特异性肠化生及上皮内瘤变的检出率高于非老年人患者,临床应加强对老年高危人群的随访.     

幽门螺杆菌与胃粘膜相关淋巴组织淋巴瘤(附6例报告)

胃粘膜相关淋巴组织淋巴瘤 ,是原发于胃的低度恶性淋巴瘤 ,来源于胃粘膜相关淋巴组织( mucosa associated,lumphoid tissue.MALT)故名。国外报道年发生率在 5.9～ 7.1 /1 0万 [1] ,国内尚未见这方面的统计 ,但近些年病例报告逐年增多。我科自 1 996～ 1 999年 ,经内镜活检和活检后手术病理组织检查确诊 6例 ,报道如下。1　临床资料1.1　一般资料　本组胃 MALT淋巴瘤 6(男 4,女2 )例 ,年龄 1 7～ 62岁 ,病程 5个月～ 3年不等 ;学生1例、工人 2例、农民 3例。1.2 　临床主要症状、体征　有上腹部疼痛、腹部饱胀、嗳气、食欲减退 ;反复呕血…     

胰腺实性-假乳头状瘤1例

患者女,29岁,左侧腰部间歇性胀痛不适10个月余.既往有肾囊肿病史, B超复查肾囊肿时发现胰尾部约5 cm×5 cm占位性病变.其他体检正常.考虑胰腺肿瘤,剖腹探查行胰腺肿瘤切除术,术中发现肿瘤与脾脏粘连紧密,连同脾脏一并切除.     

3112例胃黏膜活检的病理分析

本文收集了我院1989-2003年期间的胃黏膜活检3112例病理诊断的资料。统计中发现，胃癌592例，慢性浅表性胃炎1192例。糜烂性胃炎260例。慢性萎缩性胃炎216例，胃黏膜炎性息肉180例。胃霉菌病12例，疣状胃炎32例，胃黏膜不典型增生60例。慢性胃溃疡病564例。胃血吸虫病4例。同时。对236例胃癌的大体标本进行分析。发现早期胃癌40例，胃镜检出胃癌中早期胃癌比例为16.95％(40/236)。从中肯定了纤维内窥胃镜活检病理学诊断的临床实用价值，尤期在胃癌的早期发现、早期诊断和早期治疗中的重要意义。     

老年人Barrett食管的内镜表现及病理特征分析

Objective To explore the similarities and differences in endoscopic and pathological characteristics between elderly and non-elderly patients with Barrett esophagus (BE). Methods Three hundred and seventy-one cases with BE were divided into elderly group (n=254) and nonelderly group (n=117). The detection rate, endoscopic findings and pathological changes were assessed. Results The detection rate of BE was 2.9% in the elderly, and 0. 9% in the non-elderly(χ2 =127.8, P＜0.01). The 112 cases (44.1%) of the elderly had reflux symptoms, and so did 87cases (66.7%) of the non-elderly (χ2 =55.9, P＜0.01). The detection rate of BE in the two groups was increased year by year from 2004 to 2008. The detection rate of ring pattern was significantly higher in elderly group than in non-elderly group (28.7% vs. 10.3%, χ2=14.5, P＜0.01). Nonelderly patients had higher rate of island pattern than elderly patients (59.5% vs. 71.7%, χ2=4.7,P＜0.05). There were significant differences in the rate of specialized intestinal metaplasia between elderly and non-elderly patients (42.1% vs. 27.4%, χ2=6.9, P＜0.01). The difference in low and medium grade intraepithelial neoplasm between the two groups had statistical significance (21.3% vs.11.1%, χ2=4.9, P＜0.05). There were two cases with adenocarcinoma in elderly group, but no case was found in non-elderly group. The detection rate of H. pylori was comparable between elderly group and non-elderly group (35.5% vs. 40.9%, χ2=0.40, P＞0.05). Conclusions The elderly patients have the 3.2 times higher detection rate of BE than non-elderly patients. The detection rates of specialized intestinal metaplasia and intraepithelial neoplasm are higher in elderly group than in nonelderly group.     

胃黏膜相关淋巴组织淋巴瘤临床与内镜诊断分析

目的:探讨胃黏膜相关淋巴组织(MALT)淋巴瘤的临床和内镜下表现,提高对胃MALT淋巴瘤早期诊断率.方法:总结我院1992年2月～2003年6月经内镜检查、组织病理、免疫组化确诊为胃MALT淋巴瘤的18例临床资料并进行分析.结果:18例患者从发病到就诊时间平均5.6个月,男性比女性为5比1.首发症状为上腹部疼痛,依次有腹部饱胀、反酸嗳气、恶心呕吐、食欲减退、呕血与黑便、贫血消瘦等临床表现.内镜下形态表现分弥散浸润型12例、多发溃疡型4例、隆起糜烂型2例.形态表现为多部位、多种形态和病变范围广为特征.内镜下常误诊为胃癌、溃疡等,需经病理学、免疫组化检查确诊.本组17例(94.5%)Hp阳性,2例经根除Hp治疗获治愈.结论:胃MALT淋巴瘤起病较隐匿、病程较长.症状、体征不具特异性.内镜下形态呈多样性,病变累及范围广、部位多.多点深取活检及病理学、免疫组化检查是提高胃MALT淋巴瘤确诊率和早期诊断率的重要方法.Hp感染与胃MALT淋巴瘤密切相关.     

子宫内膜异位症145例临床病理分析

目的 观察不同部位子宫内膜异位症的病理形态特征.方法 对笔者所在医院及会诊的145例子宫内膜异位症的临床和病理资料进行复查与分析. 结果 子宫内膜异位症以41～50岁为发病高峰,占51.72%.我们收集资料中,最小者为20岁,最大者为63岁.其病变部位以子宫肌壁内为最多,占62.75%.笔者资料中还可见到有卵巢、输卵管、会阴、腹壁皮肤及盆腔淋巴结等部位.其病理特征,异位的子宫内膜大都显示正常之子宫内膜腺体和间质,形成较大囊肿者,其囊壁可见异物肉芽肿组织,含铁血黄素的巨噬细胞等. 结论子宫内膜异位症是妇产科较为常见的多发病,也是病理科较常遇到的瘤样病变,诊断较易,主要是与转移性高分化腺癌进行区别.