胃黏膜低高级上皮内瘤变的临床特征分析

目的：分析胃黏膜上皮内瘤变的临床特征以指导临床。方法：收集自2011年7月-2013年6月我院消化内镜中心所检出的胃黏膜上皮内瘤变患者294例,其中低级别上皮内瘤变（LGIN）的患者有170例,高级别上皮内瘤变（HGIN）的患者124例,分析它们的临床特征,比较它们在一般情况、病灶形态、HP感染、胃黏膜萎缩、肠化等方面的差异。结果：（1）胃黏膜上皮内瘤变临床常见,老年人多发,以胃窦、胃角常见,同级别上皮内瘤变在性别、年龄、临床症状、病灶形态、HP感染、胃黏膜萎缩肠化等方面无明显差异,P〉0.05。（2）HGIN的发病年龄、HP感染、胃黏膜萎缩肠化率分别为（74.8±13.8）岁、59.7%、46.0%、59.7%,均要明显高于LGIN组（62.2±14.2）岁、48.2%、34.7%、48.8%],HGIN癌变率也明显高于LGIN组（49.2%VS 6.5%）,P〈0.05。而两组在性别、临床表现、病变部位及形态上无明显差异。结论：HGIN易癌变,常伴有HP感染、胃黏膜萎缩、肠化,应加强内镜随访。

Clinical Characteristics Analysis of Gastric Mucosa Intraepithelial Neoplasia

Objective：This study was designed to analysis the clinical features of gastric mucosa intraepithelial neoplasia.To guide clinical treatment.Methods：Collected 294 patients with gastric IN which confirmed by biopsy in our digestive endoscopy center since July 2011 to June 2013,the 170 cases were low-grade intraepithelial neoplasia（LGIN）and124cases were high-grade intraepithelial neoplasia（HGIN）.Analyzed their clinical features,compared their differences in the general case,the lesion morphology,HP infection,intestinal mucosal atrophy and other aspects.Results：（1）In clinical gastric mucosa intraepithelial neoplasia is very commom,especially in the elderly,mainly occurred in gastric antrum and angle of stomach.There are no significant differences in gender,age,clinical symptoms,lesion morphology,HP infection,intestinal mucosal atrophy and so among the same level intraepithelial neoplasia cases.（2）The onset age,HP infection rate,intestinal mucosal atrophy rate of HGIN group respectively are（74.8±13.8）years old,59.7%,46.0%and 59.7%,are significantly higher than those of LGIN group（62.2±14.2）years old,48.2%,34.7%,48.8%].The canceration rate of HGIN group is also significantly higher than LGIN group（49.2%VS 6.5%）.The two groups have no significant differences in gender,clinical manifestations,and morphology of the lesion.Conclusion：HGIN is prone to turning cancerous,often accompanied by HP infection,gastric intestinal metaplasia atrophy,endoscopic follow-up should be strengthened.