Hp相关性胃疾病与胃肠化生、不典型增生的关系

目的探讨Hp感染与肠化生、不典型增生等胃癌前期病变的关系.方法693例胃病患者,分慢性浅表性胃炎(CSG)、慢性萎缩性胃炎(CAG)、胃溃疡(GU)及十二指球部溃疡(DU)等四组,胃镜下观察粘膜病变、溃疡部位及性质,胃镜下取材,常规HE染色后观察组织学改变、Giemsa染色后观察Hp感染程度,统计分析Hp感染与肠化生、不典型增生等的关系.结果四组胃疾病中,Hp感染程度与肠化尘程度差异显著(P＜0.01),DU组的Hp感染率高于其它组(P＜0.01),CAG组的胃肠化生率最高(P＜0.05);Hp阳性标本中,CAG组的胃肠化及不典型增生最高(P＜0.01)Hp阴性标本中,CAG组的胃肠本的胃肠化和不典型增生发生率与Hp阴性标本的发生率有显著差异(P＜0.05).结论Hp与CAG并存时,癌前病变发生率最高,其次为GU;建议在临床上,抗Hp治疗和对CAG、GU的治疗同时进行,并内镜随访.

The relationship between intestinal metaplasia, dysplasia and Hp relatedgastric diseases

Objective To investigate the relationship between Hp infection and intestinal metaplasia and dysplasia in common gastric diseases. Methods The changes of gastric mucous, the position and the nature of the ulcer from 693 cases of patients, including chronic superficial gastritis(CSG), chronic atrophic gastritis(CAG),gastric ulcer(GU) and duodenal ulcer(DU), were observed with gastroscopy, biopsies from gastric body and antrumn were stained with HE and Giemsa, and then to analysis the pathology and to observe Hp infection respectively, statisitics were carried out to analysis the relationship between Hp infection and intestinal metaplasia and dysplasia.Results: Significant difference was found between Hp infection and intestinal metaplasia(P<0.01) among 4 groups; Hp infection rate in Du was higher than that in any other three groups (P<0.01); the rate of intestinal metaplasia in CAG was the highest in these 4 groups(P<0.05) and in those of H.pylori positive(P<0.01); in H.pylori negative cases, the rate of intestinal metaplasia was the highest ir. CAG,while for dysplasia, the highest rate was in GU(P<0.01);there was significant difference between H.pylori positive group and H.pylori negative group in CAG both in the rate of intestinal metaplasia and in the rate of dysplasia. ConclusiomThe frequency of intestinal metaplasia and dysplasia was the highest in CAG when combined with Hp infection. Hp eradication and the treatment of CAG and GU should regard edhighly and gastroscopy be taken timely.