胃黏膜肠化生的逆转性问题
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李 凯, 唐志鹏, 郑丰杰, 洪原淑
胃黏膜肠化生;胃癌前病变;胃癌;逆转性,李凯,唐志鹏,洪原淑,郑丰杰,通讯作者:,电话:,收稿日期:,接受日期:,Discussiononthereversibilityofgastricintestinalmetaplasia,KaiLi,Zhi-PengT
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李凯, 唐志鹏, 洪原淑, 上海中医药大学附属龙华医院 上海市 200032
郑丰杰, 北京中医药大学 北京市 100029
通讯作者: 李凯, 200032, 上海市, 上海中医药大学附属龙华医院消化内科. hellolikai@163.com
电话: 021-27015860
收稿日期: 2006-09-15 接受日期: 2006-10-18
Discussion on the reversibility of gastric intestinal metaplasia
Kai Li, Zhi-Peng Tang, Feng-Jie Zheng, Yuan-Shu Hong
Kai Li, Zhi-Peng Tang, Yuan-Shu Hong, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
Feng-Jie Zheng, Beijing University of Chinese Medicine, Beijing 100029, China
Correspondence to: Kai Li, Department of Gastroenterology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032,China. hellolikai@163.com
Received: 2006-09-15 Accepted: 2006-10-18
AbstractGastric intestinal metaplasia (IM), as precancerous lesion of the stomach, is closely associated with the development of gastric cancer. Whether gastric IM can be reversed is still in controversy. Epidemiological evidence showed that IM was reversible after long-term following up, but the reversed degree was low. Besides H pylori infection, deficiency of vitamin C in the gastric mucosa, shortage of gastric acid and/or bile reflux can cause this precancerous condition. The pathogenesis of gastric IM, in which H pylori virulence factors, intestine-specific transcription factors, and microsatellite instability are involved, is being investigated at the present time, but it can’t be affirmed that IM is a kind of phenotype alteration in gastric epithelial cells induced by stem cell mutation. It is fairly difficult to make diagnosis for IM unless careful endoscopic evaluation is performed and proper biopsy sites are selected. Eradication of H pylori alone may not be enough to reverse IM, and its combination with other chemopreventive agents and/or Chinese medicine may be an effective strategy ......
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