胃息肉的特点及其与幽门螺杆菌感染的关系

目的 分析胃息肉的临床、内镜、病理特点及与幽门螺杆菌(Hp)的关系.方法 通过胃镜活检证实的胃息肉被纳入分析.分析不同病理类型胃息肉在年龄、部位、大小、Hp状态方面的差异,不同性别胃息肉病理类型的差异,以及不同部位胃息肉大小的差异.结果 纳入440例胃息肉.胃息肉随年龄增长而增多,胃底腺息肉多见于女性,胃底腺、 增生性、炎性及腺瘤性息肉分别为274、138、26、2例,贲门、胃底、胃体、胃窦及幽门息肉分别为22、234、106、75、3例.<1 cm、1～1.9 cm、≥2 cm的息肉分别为392、40、8例.372例胃息肉经组织切片染色检测了Hp,其中Hp阳性的胃底腺、增生性、炎性及腺瘤性息肉分别为0、57、9、1例.不同部位的胃息肉存在大小的差异(P<0.05),各病理类型胃息肉的部位、大小及Hp状态也存在差异(P<0.05).结论 胃息肉病理谱发生了改变,增生性息肉与Hp阳性相关,而胃底腺息肉与Hp阴性相关.掌握胃息肉的特点有助于胃镜检查对胃息肉性质的初步判断,指导治疗及随访观察.

Characteristics of gastric polyps and correlation with helicobacter pylori infection

Objective To analyze the clinical, gastroscopic and pathological characteristics of gastric polyps (GPs) and their correlation with helicobacter pylori infection (Hp). Methods A total of 440 GPs cases confirmed by endoscope and biopsy were recruited. The differences in age, site, size and Hp status of GPs according to various pathological types and sex were analyzed. Results The incidence of GPs increased with age. Fundic gland polyps (FGPs) were more likely to be found in female. The number of FGPs, hyperplastic polyps (HPs), inflammatory polyps (IPs) and adenomatous polyps (APs) was 274, 138, 26, and 2, respectively. The number of polyps in cardia, fundus, body, antrum and pylorus was 22, 234, 106, 75 and 3, respectively. The number of polyps <1 cm, 1-1.9 cm, and ≥2 cm was 392, 40 and 8, respectively. A total of 372 GPs were checked for Hp with tissue slice dyeing. FGPs, HPs, IPs and APs cases with Hp positive was 0, 57, 9, and 1, respectively. There was difference in size of GPs according to various sites (P<0.05). There were differences in site, size and Hp status of GPs according to various pathological types (P<0.05). Conclusion The spectrum of GPs pathology changes. HPs correlates with Hp positively; however, FGPs correlates with Hp negatively. Characteristics of gastric polyps are helpful for preliminary judgment of GPs during gastroscopy, guidance of therapy and follow-up.