胃癌及癌前病变胃粘膜的粘液组织化学研究

本文应用粘液组织化学方法对168例肠化生、96例异型增生和89例胃癌胃粘膜活检标本进行观察,发现87.6％的胃癌和40.6％的异型增生组织有异常粘液分泌;不全结肠型肠化生和硫酸粘液阳性肠化生在癌旁和异型增生的检出率显著地高于萎缩性胃炎组(P<0.05);伴不全结肠型肠化生和伴其它型肠化生的胃癌患者平均年龄分别为59.5岁和54.4岁、男女比为6∶1和2.25∶1.结果提示有异常粘液分泌的异型增生、伴不全结肠型化生的异型增生、不全结肠型化生的高龄男性、伴不全结肠型化生的胃良性疾病和硫酸粘液阳性肠化生宜被看作是胃癌的癌前病变,其中前三组的癌变趋向性更大.

Histochemical Study of Mucosubstance in Gastric Cancer and Precancerous Lesions of Stomach

Gastric biopsy specimens from 168 patients with intestinal metaplasia (IM), 96 patients with dysplasia (Dys) and 91 patients with gastric cancer (GC) were studded by mucin stains for the presence of mucin and the type of IM. The results showed that 83 patients with GC(87.6%) and 39 patients with Dys (40.6%) secreted non-neutral mucin. The incidence of type IIb of IM in patients with GC was significantly higher than that in chronic atrophic gastritis (CAG) patienls. Sulphomucin-positive IM was more common in patients with GC and Dys than in patients with CAG. The average age of GC patients with and without type IIb of IM was 59.5 and 54.4 yrs, respectively. The male and female ratio in patients of type IIb IM w(?)s 6:1, but it was 2.3:1 in those without type IIb IM. Our results reveal that the follwing 5 kinds of pathological changes, namely(1) Dys secreting non-neutral mucin or showing negative mucin stain, (2) Dys with type IIb IM, (3) type IIb IM in elderly males. (4) sulphomucin-positive IM, and (5) type IIb IM in benign gastric diseases, might be the precancerous lesions of GC.