胃镜结合病理分析在慢性萎缩性胃炎诊断中的意义

[目的]探讨胃镜结合病理分析在慢性萎缩性胃炎诊断中的意义。[方法]对70例CAG的胃镜下表现与病理诊断进行相关性分析,分别计算胃镜下各种表现对病理诊断CAG的敏感性和特异性。[结果]70例患者胃镜直视下诊断为CAG者70例,病理诊断为CAG者58例,其中伴肠上皮化生26例,异型增生11例。慢性浅表性胃炎(CSG)12例,总体而言,CAG胃镜与病理诊断符合率为82.86%。胃镜下CAG的表现特征主要有3点:A黏膜变薄、皱襞变平;B:血管显露,红白相间以白为主;C:黏膜粗糙不平,呈颗粒状或结节样改变,对于黏膜萎缩而言,其阳性预测值:A+B≥70%,A+B+C=96.77%,差异显著(P﹤0.05);对肠上皮化生而言,A+B的阳性预测值仅为16.00%,异型增生中诊断中,C的阳性率在28.57%。Hp检查结果其中阳性者43例,占61.42%,阴性者27例,占38.58%,其中Hp感染阳性患者与胃黏膜的3种病理改变有关,三者比较,黏膜萎缩与肠化、异型增生之间差异均有统计学意义(P﹤0.01)。[结论]慢性萎缩性胃炎胃镜和病理诊断有一定相关性,胃镜和病理检查的紧密结合有利于慢性萎缩性胃炎的正确诊断。

STUDY ON THE SIGNIFICANCE OF ENDOSCOPIC AND PATHOLOGIC ANALYSES IN DIAGNOSIS OF CHRONIC ATROPHIC GASTRITIS

[Objective]To investigate the significance of endoscopic and pathologic analyses in diagnosis of chronic atrophic gastritis.[Methods]The correlation between gastroscopic manifestations and pathologic diagnosis of 70 patients with chronicatrophic gastritis was analyzed,and the sensitivity and specificity of CAG through various gastroscopic were calculated respectively.[Results]Of the 70 patients,CAG 58 cases,CAG and CSG 12 cases were diagnosed by gastroscopy;the pathological diagnosis were CAG 28 cases,CAG a...