慢性萎缩性胃炎的胃镜下表现与病理诊断对照分析

目的比较慢性萎缩性胃炎胃镜诊断与病理诊断结果,探讨相关性。方法对淮南市第一人民医院胃镜诊断为慢性萎缩性胃炎的患者86例,对病变处进行活检进行病理检查,内镜下表现与病理检查的结果进行对比研究,了解慢性萎缩性胃炎内镜表现同病理检查之间的相关性,计算其之间诊断慢性萎缩性胃炎符合率。结果内镜诊断86例慢性萎缩性胃炎中病理诊断65例,其之间符合率为75.6%,伴肠上皮化生42例,伴上皮内瘤变19例。胃镜下具有黏膜皱襞变平甚至消失,黏膜红白相间,白相为主,血管透见及黏膜呈颗粒或结节状表现的病理诊断确诊为慢性萎缩性胃炎符合率91.7%,胃镜下具有黏膜呈颗粒或结节状表现病理诊断确诊为慢性萎缩性胃炎符合率79.3%,其符合率之间比较差异无统计学意义（P〉0.05）。仅见黏膜皱襞变平甚至消失,黏膜红白相间,白相为主,血管透见内镜表现,病理诊断慢性萎缩性胃炎符合率42.9%,其符合率与胃镜下具有黏膜呈颗粒或结节状表现及具有慢性萎缩性胃炎内镜下各种表现之间比较差异有统计学意义（P〈0.01）。结论经过对慢性萎缩性胃炎的内镜诊断和病理结果分析,两者的符合率有一定的差异,故对于慢性萎缩性胃炎的诊断应将内镜诊断和病理诊断结合起来,二者结合可提高对慢性萎缩性胃炎的确诊率。

Control analysis of gastroscopic manifestation and pathological diagnosis for chronic atrophic gastritis

Objective To compare the gastroscopic manifestation and pathological diagnosis of chronic atrophic gastritis,and discuss their correlation. Methods The results of gastroscopy and pathological diagnosis of 86 patients with chronic atrophic gastritis were collected and compared to study the correlation and coincidence rate between gastroscopy and pathological diagnosis. Results Sixty five patients were confirmed the chronic atrophic gastritis by the pathological diagnosis in 86 cases who were diagnosed by gastroscopy with a coincidence rate of 75. 6%,in which 42 cases were with intestinal metaplasia,19 cases with intraepithelial neoplasia. 91. 7% of patients with small or even disappeared mucosal folds,focal white or mixed red and white lesion of mucosa,visible vascular network,granular and nodular mucosa under the gastroscope were confirmed by the pathological diagnosis; and 79. 3% of patients with granular and nodular mucosa under the gastroscope were confirmed by the pathological diagnosis; there was not statistical difference between these two appearance of mucosa（ P〉 0. 05）. Only 42. 9% of patients with small or even disappeared mucosal folds,focal white or mixed red and white lesion of mucosa,and visible vascular network under the gastroscope were confirmed by the pathological diagnosis,the statistical difference was found as compared with those mucosa above（ P 〈0. 01）. Conclusion There is an incomplete coincidence outcome between the gastroscopy and pathological diagnosis,the combination of the two methods should improve the diagnosis rate of chronic atrophic gastritis.