肠化生和肠型胃癌内镜及病理特点分析

目的通过对肠化生及肠型胃癌病例的回顾性分析,探讨肠化生和肠型胃癌的关系以及影响肠化生的因素.方法收集1998～2003年间行胃镜检查的病例共14766人次进行统计分析.结果中、重度肠化生和肠型胃癌检出年龄呈递增趋势,各组间有显著性差异(P＜0.01);肠型胃癌的检出年龄以胃角最小,与其他部位相比有显著的差异(P＜0.01),胃窦、胃体、胃底和贲门癌之间年龄无显著性差异;肠型胃癌男女检出率分别为3.44%和1.18%,性别差异有显著性(P＜0.01),中重度肠化生检出率分别为5.46%和5.17%,性别之间无显著差异(P＞0.05);发生中度和重度肠化生的胃窦粘膜HP阳性检出率分别为37.44%和35.80%,较无肠化生和轻度肠化生病例高(30.19%);肠化生程度和粘膜萎缩程度相关.结论肠化生在年龄上早于肠型胃癌出现,肠化生与肠型胃癌性别上的分布不一致;中重度肠化生和HP感染有关;肠化生程度和萎缩程度相关.

Analysis of the Endoscopic and Pathologic Characteristics of Intestinal Metaplasia and Intestinal Type Gastric Cancer

] Objective To explore the relation between intestinal metaplasia and intestinal type gastric cancer, and the impact factors of intestinal metaplasia, by making a retrospective analysis on the patients with intestinal metaplasia and intestinal type gastric cancer. Methods Totally 14 766 person times, examined by gastroscope from 1998 to 2003, were selected as the cases for the statistical analysis. Results The age, at which moderate, severe degree intestinal metaplasia and intestinal type gastric cancer could be detected, showed an increasing trend, and there were significant differences among the age groups (P<0.01). The detected age of the intestinal type gastric cancer was lowest at the gastric incisura, which was significantly different from other parts (P<0.01), and the detected age at gastric antrum, corpus, fundus and cardia cancer were not significantly different from one another. The detective rate of the intestinal type gastric cancer in male and female was 3.44% and 1.18% respectively which had significant difference (P<0.01), and the detected rate of moderate, severe degree intestinal metaplasia was 5.46% and 5.17%, respectively, which had no significant difference (P>0.05). The Hp positive rate of gastric antrum with moderate, severe degree intestinal metaplasia (37.44% and 35.80%, respectively) was higher than that with no or only slight intestinal metaplasia (30.19%). The degree of intestinal metaplasia was related to the gastric mucous atrophy. Conclusions Intestinal metaplasia takes place at earlier ages than intestinal type gastric cancer and the both had a different distribution in the sexes. The moderate, severe degree intestinal metaplasia is related to the Hp infection and its degree is related to the gastric mucous atrophy.