目的:分析三叶因子3(TFF3)在不同胃黏膜病变中的表达及其与间质微血管密度(MVD)值的关系,探讨其在胃癌、癌前病变及胃腺瘤发生、发展中的作用.方法:应用免疫组织化学PV6000法检测20例正常胃黏膜、20例胃腺瘤、20例萎缩性胃炎伴肠化生、2...目的:分析三叶因子3(TFF3)在不同胃黏膜病变中的表达及其与间质微血管密度(MVD)值的关系,探讨其在胃癌、癌前病变及胃腺瘤发生、发展中的作用.方法:应用免疫组织化学PV6000法检测20例正常胃黏膜、20例胃腺瘤、20例萎缩性胃炎伴肠化生、20例不典型增生、40例胃癌组织中TFF3的表达,同时检测MVD值,以抗CD34标记.结果:TFF3在胃腺瘤、萎缩性胃炎伴肠化生、不典型增生和胃癌各组表达均高于正常组(50.0%,65.0%,70.0%,57.5% vs 5.0%,均P<0.01).胃癌MVD值高于正常胃黏膜、胃腺瘤、萎缩性胃炎伴肠化生和不典型增生(30.65±6.04 vs 14.87±3.06,22.33±3.78,23.16±3.20,25.22±4.66,均P<0.01),各组MVD值均高于正常胃黏膜组(均P<0.01).TFF3表达和MVD值与胃癌淋巴结转移和分期有关(均P<0.05),MVD值还与胃癌浸润深度有关(P<0.05).TFF3阳性表达组的MVD值明显高于TFF3阴性组(34.53±4.45 vs 25.39±3.25,P<0.01).结论:TFF3可能是胃黏膜癌变过程中的早期分子事件,在胃黏膜癌变和癌变后的恶性演进过程中起作用,对胃癌早期诊断和预测胃癌发生转移可能具有重要的提示作用.展开更多
Objective： Probe-based confoeal laser endomicroscopy （pCLE） technique may improve the diagnosis of gastric mucosal lesions allowing acquisition of high-resolution in vivo images at the cellular and mierovaseular le...Objective： Probe-based confoeal laser endomicroscopy （pCLE） technique may improve the diagnosis of gastric mucosal lesions allowing acquisition of high-resolution in vivo images at the cellular and mierovaseular levels. This study aims to evaluate the accuracy of pCLE for the differential diagnosis of non-neoplastic and neoplastic gastric lesions.Methods： Twenty gastric mucosal lesions from 10 patients were evaluated during endoscopic procedure and were examined by pCLE. Diagnostic pCLE was followed by biopsies or endoscopic resection of suspected lesions. A senior pathologist evaluated the specimens and was blinded to the pCLE results.Results： Patients＇ mean age was 68.3 （range, 42-83） years and six were men. Thirteen suspicious flat or elevated lesions （classified as 0-Is, 0-IIa or 0-IIa ＋ IIc） and seven pre-malignant lesions （atrophy and intestinal metaplasia） were evaluated. One patient was studied during his long-term follow-up after partial gastrectomy and presented severe atrophy, intestinal metaplasia, and xanthomas at the stump mucosa. The location of gastric lesions was in the body （n=10 lesions）, the antrum （n=9） and the incisura angularis （n=1）. All neoplastic lesions and all but one benign lesion were properly diagnosed by pCLE. pCLE incorrectly diagnosed one small antrum lesion as adenoma, however the final diagnosis was intestinal metaplasia. The final histological diagnosis was neoplastic in 9 and benign lesions in 11. In this small case series, pCLE accuracy was 95% （19/20 lesions）.Conclusions： pCLE is accurate for real time histology of gastric lesions, pCLE may change the management of patients with gastric mucosal lesions, guiding biopsies and endoscopic resection, and avoiding further diagnostic workup or unnecessary therapy.展开更多
背景:内镜检查在发现胃早期肿瘤性病变中居重要地位,但不同内镜技术的诊断准确性存在差异。目的:比较常规白光内镜与放大内镜联合窄带成像技术(ME-NBI)对胃早期肿瘤性病变的诊断价值。方法:连续性收集2016年1月—2018年6月在上海仁济医...背景:内镜检查在发现胃早期肿瘤性病变中居重要地位,但不同内镜技术的诊断准确性存在差异。目的:比较常规白光内镜与放大内镜联合窄带成像技术(ME-NBI)对胃早期肿瘤性病变的诊断价值。方法:连续性收集2016年1月—2018年6月在上海仁济医院经白光内镜检查怀疑胃早期肿瘤性病变并取得活检病理结果的患者,择期行ME-NBI并记录白光内镜和ME-NBI诊断;对首次活检病理为非肿瘤性病变者行第二次靶向活检。病理确诊肿瘤性病变者行内镜或外科手术治疗并纳入研究。以术后病理结果为金标准,评估白光内镜和ME-NBI鉴别肠型胃腺瘤与早期胃癌的诊断效能。结果:共纳入301例患者(301处病灶),其中肠型胃腺瘤171例,早期胃癌130例。两名内镜诊断医师的观察者间一致性良好(白光内镜:κ=0.70;ME-NBI:κ=0.81)。ME-NBI鉴别肠型胃腺瘤与早期胃癌的敏感性(89.2%对76.9%)、特异性(90.6%对71.9%)、阳性预测值(87.9%对67.6%)、阴性预测值(91.7%对80.4%)和准确性(90.0%对74.1%)均显著高于白光内镜( P <0.05)。结论:与白光内镜相比,ME-NBI能更好地鉴别肠型胃腺瘤与早期胃癌。展开更多
文摘目的:分析三叶因子3(TFF3)在不同胃黏膜病变中的表达及其与间质微血管密度(MVD)值的关系,探讨其在胃癌、癌前病变及胃腺瘤发生、发展中的作用.方法:应用免疫组织化学PV6000法检测20例正常胃黏膜、20例胃腺瘤、20例萎缩性胃炎伴肠化生、20例不典型增生、40例胃癌组织中TFF3的表达,同时检测MVD值,以抗CD34标记.结果:TFF3在胃腺瘤、萎缩性胃炎伴肠化生、不典型增生和胃癌各组表达均高于正常组(50.0%,65.0%,70.0%,57.5% vs 5.0%,均P<0.01).胃癌MVD值高于正常胃黏膜、胃腺瘤、萎缩性胃炎伴肠化生和不典型增生(30.65±6.04 vs 14.87±3.06,22.33±3.78,23.16±3.20,25.22±4.66,均P<0.01),各组MVD值均高于正常胃黏膜组(均P<0.01).TFF3表达和MVD值与胃癌淋巴结转移和分期有关(均P<0.05),MVD值还与胃癌浸润深度有关(P<0.05).TFF3阳性表达组的MVD值明显高于TFF3阴性组(34.53±4.45 vs 25.39±3.25,P<0.01).结论:TFF3可能是胃黏膜癌变过程中的早期分子事件,在胃黏膜癌变和癌变后的恶性演进过程中起作用,对胃癌早期诊断和预测胃癌发生转移可能具有重要的提示作用.
基金partially supported by FINEP(Financiadora de Estudos e Projetos)from Brazilian Ministry of Health
文摘Objective： Probe-based confoeal laser endomicroscopy （pCLE） technique may improve the diagnosis of gastric mucosal lesions allowing acquisition of high-resolution in vivo images at the cellular and mierovaseular levels. This study aims to evaluate the accuracy of pCLE for the differential diagnosis of non-neoplastic and neoplastic gastric lesions.Methods： Twenty gastric mucosal lesions from 10 patients were evaluated during endoscopic procedure and were examined by pCLE. Diagnostic pCLE was followed by biopsies or endoscopic resection of suspected lesions. A senior pathologist evaluated the specimens and was blinded to the pCLE results.Results： Patients＇ mean age was 68.3 （range, 42-83） years and six were men. Thirteen suspicious flat or elevated lesions （classified as 0-Is, 0-IIa or 0-IIa ＋ IIc） and seven pre-malignant lesions （atrophy and intestinal metaplasia） were evaluated. One patient was studied during his long-term follow-up after partial gastrectomy and presented severe atrophy, intestinal metaplasia, and xanthomas at the stump mucosa. The location of gastric lesions was in the body （n=10 lesions）, the antrum （n=9） and the incisura angularis （n=1）. All neoplastic lesions and all but one benign lesion were properly diagnosed by pCLE. pCLE incorrectly diagnosed one small antrum lesion as adenoma, however the final diagnosis was intestinal metaplasia. The final histological diagnosis was neoplastic in 9 and benign lesions in 11. In this small case series, pCLE accuracy was 95% （19/20 lesions）.Conclusions： pCLE is accurate for real time histology of gastric lesions, pCLE may change the management of patients with gastric mucosal lesions, guiding biopsies and endoscopic resection, and avoiding further diagnostic workup or unnecessary therapy.
文摘背景:内镜检查在发现胃早期肿瘤性病变中居重要地位,但不同内镜技术的诊断准确性存在差异。目的:比较常规白光内镜与放大内镜联合窄带成像技术(ME-NBI)对胃早期肿瘤性病变的诊断价值。方法:连续性收集2016年1月—2018年6月在上海仁济医院经白光内镜检查怀疑胃早期肿瘤性病变并取得活检病理结果的患者,择期行ME-NBI并记录白光内镜和ME-NBI诊断;对首次活检病理为非肿瘤性病变者行第二次靶向活检。病理确诊肿瘤性病变者行内镜或外科手术治疗并纳入研究。以术后病理结果为金标准,评估白光内镜和ME-NBI鉴别肠型胃腺瘤与早期胃癌的诊断效能。结果:共纳入301例患者(301处病灶),其中肠型胃腺瘤171例,早期胃癌130例。两名内镜诊断医师的观察者间一致性良好(白光内镜:κ=0.70;ME-NBI:κ=0.81)。ME-NBI鉴别肠型胃腺瘤与早期胃癌的敏感性(89.2%对76.9%)、特异性(90.6%对71.9%)、阳性预测值(87.9%对67.6%)、阴性预测值(91.7%对80.4%)和准确性(90.0%对74.1%)均显著高于白光内镜( P <0.05)。结论:与白光内镜相比,ME-NBI能更好地鉴别肠型胃腺瘤与早期胃癌。
