贲门癌癌旁和无症状人群贲门黏膜活检组织肠上皮化生检测

目的:探讨贲门癌癌旁组织及无症状人群贲门黏膜活检组织肠上皮化生(IM)的分布特征.方法:采用艾显蓝-雪夫(AB-PAS)和高铁二胺-艾显兰(HID-AB)黏液组织化学染色法,对河南贲门癌高发区70例贲门癌癌旁组织和320例无症状人群贲门黏膜活检组织中的IM进行检测.结果:贲门癌癌旁组织的IM检出率38.5%(27/70),高于无症状人群贲门黏膜活检组织中的IM检出率4.4%(14/320)(x2=71.394 5,P＜0.01).贲门癌癌旁组织IM不完全型占92.6%(25/27),完全型IM占7.4%(2/27);无症状人群贲门黏膜的IM不完全型占7.1%(1/14),完全型IM占92.9%(13/14);2者比较,差异有统计学意义(x2=29.015 7,P＜0.01).贲门癌旁组织的IM大肠型占59.2%(16/27),小肠型占40.8%(11/27);无症状人群贲门黏膜的IM小肠型占92.9%(13/14),大肠型占7.1%(1/14);2者比较,差异有统计学意义(x2=10.317 3,P＜0.01).结论:IM可能是河南贲门癌高发区贲门癌癌前病变的一种重要表现形式;不完全型和大肠型IM可能是贲门癌前病变的独特组织学类型.

Histochemical studies on intestinal metaplasia in tissue adjacent to gastric cardia adenocarcinoma and gastric cardia biopsy tissue from symptom free subjects at the high-incidence area in Henan

Aim: To characterize the histochemistry of intestinal metaplasia (IM) in tissue adjacent to gastric cardia adenocarcinoma (GCA) and gastric cardia biopsy tissue from symptom-free subjects at the high-incidence area in Henan. Methods:AB-PAS and HID-AB histochemical methods were performed to detect IM in tissue adjacent to GCA(n=70) and gastric cardia biopsy tissue from symptom-free subjects(n=320). Results: The detection rate of IM in tissue adjacent to GCA (38.5%) was significantly higher than that in cardia biopsy tissue from symptom-free subjects (4.4%) (P< 0.01 ); the detection rate of incomplete type IM in tissue adjacent to GCA (92.6%) was significantly higher than that in cardia biopsy tissue from symptom-free subjects (7.1%) (P<0.01); the detection rate of intestinal-type IM in tissue adjacent to GCA (40.8%) was significantly higher than that in cardia biopsy tissue from symptom-free subjects (92.9%) (P<0.01); and that the detection rate of colonic type IM in tissue adjacent to GCA (59.2%) was significantly higher than that in cardia biopsy tissue from symptom-free subjects (7.1%) (P<0.01). Conclusion: IM might be one of important precancerous lesions for GCA. The incomplete IM and colonic type IM were unique pattern for precancerous lesions of GCA.