摘要
目的研究放大色素内镜下胃黏膜萎缩、肠上皮化生、不典型增生和早期胃癌的小凹形态特点。方法利用OlympusGIFQ240Z型电子放大内镜结合亚甲蓝染色对594例胃病患者的胃黏膜小凹进行观察,以黏膜红白色相间明显,白色区增多,白色区内小凹结构紊乱、消失为标准对黏膜萎缩进行内镜诊断,并在放大观察区域取活检送病理检查,与放大内镜下小凹形态进行对照。结果放大色素内镜对萎缩性胃炎诊断的敏感度为74.6%,特异度为90.4%,准确率为84.1%;轻度萎缩的黏膜白色区中心小凹稀疏、减少,周边的小凹无明显异常,萎缩较严重的区域小凹大面积消失,形成瘢痕样改变,周边小凹延长、迂曲明显;肠上皮化生黏膜亚甲蓝染色为淡染,小凹形态主要表现为绒毛状、斑块状和粗条纹状,其中绒毛状为最具有特征性的表现;不典型增生与早期胃癌都为亚甲蓝深染,小凹大小不等,形状不一,排列紊乱。结论胃黏膜萎缩、肠上皮化生、不典型增生和早期胃癌的小凹形态各有其特点,使用放大色素内镜有助于对病灶性质的判断和指导活检。
Objective To explore the pit patterns of mucosal atrophy, intestinal metaplasia, dysplasia of gastric mucosa and early gastric cancer by magnifying chromoendoscopy. Methods The pit patterns of gastric mucosa of 594 patients with gastrosia were observed with electronic magnifying endoscopy （Olympus GIF Q-240Z） assisted with methylene blue staining. Biopsies were taken from suspicious sites as observed after magnification for histopathologic examination. Results The diagnostic sensitivity, specificity and accuracy of magnifying chromoendoscopy for mucosal atrophy were 74. 6%, 90. 4% and 84. 1%, respectively. In the central part of mild atrophic areas gastric pits were found to be decreased in quantity or even disappeared, while in severe atrophic area, sear-like changes were seen due to the disappearance of pits, with elongation and tortuosity of surrounding. Mueosa with intestinal metaplasia was lightly stained by methylene blue, and pit patterns appeared as villi, scars or coarse lines. Mucosa of dysplasia or early gastric cancer was heavily stained by methylene blue, and gastric pits were amorphous and irregular in size. Conclusion Gastric mucosal atrophy, intestinal metaplasia, dysplasia and early gastric cancer have their peculiar pit patterns, and magnifying chomoendoseopy may be useful in the diagnosis of these lesions.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2005年第9期807-809,共3页
Medical Journal of Chinese People's Liberation Army
关键词
放大色素内镜
小凹形态
黏膜萎缩
肠上皮化生
不典型增生
早期胃肿瘤
magnifying chomoendoscopy
pit patterns
mucosal atrophy
intestinal- metaplasia
dysplasia
early gastric cancer
