摘要
目的分析早期胃癌的普通白光内镜下特征，以及早期胃癌内镜下表现与其病理类型的关系。方法对2010年1月至2014年7月由胃镜检查发现并经病理确诊的130例早期胃癌患者进行回顾性研究。采用巴黎分类标准分类，并按病灶最大径分为微小胃癌（最大径≤O．5cm）、小胃癌（0．5cm〈最大径≤1．Ocm），以及最大径〉1．0cm的早期胃癌，分析其在白光内镜下的病灶形态与病理特征。计数资料的比较采用卡方检验或Fisher确切概率法。结果早期胃癌以分化型为主（91％，118／130），形态学分类上以O-Ⅱc型最多见（55％，72／130），色调变化以发红多见（75％，97／130）。边界清晰（93％，121／130）及表面不规则（89％，116／130）是白光内镜下早期胃癌最显著的特征，但微小胃癌中病灶表面不规则者较少见（3／10）。83％（108／130）的早期胃癌病灶周围黏膜有萎缩和（或）肠上皮化生。凹陷型病灶（O-Ⅱc和O-Ⅲ型）中58％（42／73）边缘部呈毛刺状、42％（31／73）并发溃疡，而表面覆白色不透明物质多见于隆起型病灶（O-Ⅰ和O-Ⅱa型，37％，17／46）。未分化型早期胃癌全部为0-Ⅱ型，且以0-Ⅱc型（8／12）多见，未分化型癌色调发白或红白相间较多见（7／12）。结论在白光内镜下注意胃黏膜局部色调的变化，以及边界清晰和表面不规则的病灶，有助于发现早期胃癌。病灶的形态和色调有助于预判肿瘤的病理类型。
Objective To analyze the characteristics of early gastric cancer under white light endoscopy, and explore the relationship between endoscopic findings and pathological type of gastric cancer. Methods From January 2010 to July 2014, 130 pathologically comfirmed early gastric cancer detected under white light endoscopy were retrospectively analyzed. The cancers were classified according to Paris classification standard. According to maximum diameter, the lesions were divided into micro gastric cancer （40.5 cm）, small gastric cancer （0.5 cm, and 41.0 cm） and other early gastric cancer （over 1.0 era）. The morphology of lesions under white light endoscopy and under the microscope were analyzed. Chi square test or Fisher exact probability test was performed for enumeration data comparison. Results The majority of early gastric cancer was differentiated type （91%, 118/130）. The most common macroscopic morphology was 0-Ⅲc type （55%, 72/130）, and the color of lesions was mostly red （75M, 97/130）. The significant characteristics of early gastric cancer under white light endoscopy was clear boundary （93%, 121/130） and irregular surface （89M, 116/130）. However, irregular surface was rare in micro gastric cancer （3/10）. There were atrophic gastritis and/or intestinal metaplasia in surrounding mucosa of 83% （108/130） of early gastric cancer. Encroachment and accompanied by ulceration were more common in depressed lesions （0-Ⅱc and 0-Ⅲ type, 58% （42/73） and 42% （31/73）, respectively） and the white opaque of substance on the top was more common in elevated lesions （0-Ⅰ and 0-Ⅱa type 37% （17/46））. Moreover, all the undifferentiated gastric cancers were type 0-Ⅱ in which 0-Ⅱ c type （8/12） predominated. The color of undifferentiated gastric cancers was mostly white or white and red （7/12）. Conclusions Under white light endoscopy, the color change of gastric mucosa, the clear boundary line and irregular surface should be taken notice, which may facilit
出处
《中华消化杂志》
CAS
CSCD
北大核心
2015年第3期165-168,共4页
Chinese Journal of Digestion
基金
国家自然科学基金青年科学基金（81201958）,全军保健专项科研课题（12BJz04）
关键词
早期胃癌
胃镜检查
病理
形态学
Early gastric cancer
Gastroscopy
Pathology
Morphology
