摘要
目的探讨胃癌癌前病变的年龄、性别分布情况 ,其癌前状态构成及与胃癌的鉴别。方法对95 4例胃粘膜肠上皮化生、非典型增生者的临床内镜表现和病理类型进行分析 ,对 6 6例重度癌前病变疑为癌者运用免疫组化法检测其增殖细胞核抗原 (PCNA)、癌胚抗原 (CEA)的表达。结果癌前病变男性为女性的3.6 5倍 ,以 4 0～ 6 9岁者居多 (6 3.2 1% ) ,癌前状态以胃溃疡 (46 .12 % )及慢性胃炎 (31.91% )较多 ;术后病理证实为胃癌的 4 1例中PCNA阳性率为 85 .37% ,CEA阳性率为 82 .93% ,两者均呈阳性表达者为 73.17% ,显著高于两者之一为阴性或全为阴性者 (P <0 .0 1)。结论胃癌癌前病变发病与年龄、性别有关 ;癌前状态以胃溃疡、慢性胃炎为主 ;PCNA。
ObjectivesTo investigate the distribution of ages, sex and the proportion in patients with precancerous lesions as well as the differentiation between gastric cancer and precancerous lesions.MethodsThe clinical symptoms, endoscopic findings and pathological types in nine hundred and fifty four patients with intestinal metaplasia(IM) and dysplasia(Dys) were analyzed. Expressions of carcinoembryonic antigen (CEA) and proliferating cell nuclear antigen(PCNA) in specimens collected from endoscopic biopsy of 66 patients with severe grade precancerous lesions suspicious for cancer were detected by immunohistochemical method, and compared with post surgical specimens assessment.ResultsThe ratio between male and female patients was 3.65:1.The incidence of precancerous lesions was highest in patients at the age of 40～69 years old(63.21%).There were more patients with gastric ulcer (46.12%)and chronic gastritis (31.91% )than others among precancerous lesions . The positive rates of CEA and PCNA in forty one patients whose diagnosis of gastric cancer was confirmed by post surgical pathological assessment were 82.93% and 85.37% , respectively; patients showing both positivities amounted to 73.17% , significantly higher than those with either one or both negativities (P<0.01).ConclusionsThe incidence of gastric precancerous lesions is related with ages and sex of the patients. Gastric ulcer and chronic gastritis constitute the majority of precancerous conditions. Expression of PCNA and CEA is helpful to the differential diagnosis between benign and malignant gastric lesions and prediction of their prognosis.
出处
《医学临床研究》
CAS
2003年第2期88-91,共4页
Journal of Clinical Research
关键词
胃肿瘤
病理学
癌前状态
增殖细胞核抗原
癌胚抗原
stomach neoplasms/PA
precancerous conditions
proliferating cellnuclear antigen
