慢性萎缩性胃炎内镜检查与病理诊断临床对比(1)
[摘要] 目的 探讨慢性萎缩性胃炎(CAG)内镜特征及内镜诊断与病理结果的差异性，为临床有效诊治CAG提供参考依据。方法 方便选取2014年1月—2016年12月该院收治的126例内镜诊断为CAG的患者为研究对象，全部患者均于病变处取活检样本进行病理诊断。观察内镜下CAG的特征表现，比较CAG内镜检查结果和病理诊断结果并计算诊断符合率。结果 126例内镜诊断CAG患者中，91例经病理检查确诊，内镜诊断CAG符合率72.2%，其中伴肠上皮化生45例(49.5%)，伴异形增生28例(30.8%)。内镜下粘膜特征为I型、I型+II型、I型+II型+III型患者的CAG诊断率分别为33.3%、71.4%、92.9%，I型+II型+III型CAG诊断率显著高于I型和I型+II型，差异有统计学意义(P<0.05)。 结论 内镜检查下血管透见、胃粘膜白相为主，粗糙不平伴颗粒样增生同CAG病理诊断存在较高的符合率，能够为临床正确诊断CAG提供一定价值，两者联合使用更能提高诊断准确率，值得临床推广。
[关键词] 慢性萎缩性胃炎；内镜检查；病理诊断；相关性
[中图分类号] R44 [文献标识码] A [文章编号] 1674-0742(2017)04(c)-0036-03
[Abstract] Objective To discuss the endoscopy features of chronic atrophic gastritis and the differences between the endoscopy diagnosis and pathological results and provide reference for the effective diagnosis and treatment of CAG in clinic. Methods 126 cases of CAG patients admitted and treated in our hospital from January 2014 to December 2016 were conveniently selected and all patients were given the pathological diagnosis， and the features of CAG under the endoscopy were observed and the CAG endoscopy results and pathological diagnosis results were compared and the diagnosis coincidence rate was calculated. Results 91 cases were diagnosed by the pathological examination of the 126 cases， and the CAG coincidence rate of endoscopy diagnosis was 72.2%， and there were 45 cases with intestinal metaplasia， accounting for 49.5%， 28 cases with dysplastic epithelium (30.8%)， and the CAG diagnosis rate of patients whose endoscopic mucosal feature was I type +II type +III type was obviously higher than that of patients whose endoscopic mucosal feature was I type and I type + II type (92.9% vs 33.3%， 71.4%)， and the differences were statistically significant(P<0.05). Conclusion The endoscopy shows that the vascular penetration and gastric mucosa white is the main， roughness with granular hyperplasia is highly consistent with the CAG pathological diagnosis， which can provide a certain value for the clinical accurate diagnosis of CAG and the combined use of the two can better improve the diagnosis accurate rate， and it is worth clinical promotion.
[Key words] Chronic atrophic gastritis； Endoscopy； Pathological diagnosis； Correlation
慢性萎縮性胃炎(CAG)是以胃粘膜上皮萎缩、固有腺体数目减少甚至消失为特征的的一类慢性胃炎，常并发肠上皮化生和不典型增生，是目前临床已经证实的一种癌前病变，因此需加强CAG早期诊治，以预防胃癌进展，改善预后[1]。胃粘膜活检是CAG临床诊断金标准，近年来，随着内镜技术的研发与推广，内镜监测随访在CAG诊断和早期胃癌检查中发挥了重要作用，文章现以2014年1月—2016年12月该院收治的126例内镜诊断为CAG的患者为例对内镜下CAG特征表现及其与病理诊断的符合情况进行分析和探讨，现报道如下。
1 资料与方法, 百拇医药(章再军 田祖成)
[关键词] 慢性萎缩性胃炎；内镜检查；病理诊断；相关性
[中图分类号] R44 [文献标识码] A [文章编号] 1674-0742(2017)04(c)-0036-03
[Abstract] Objective To discuss the endoscopy features of chronic atrophic gastritis and the differences between the endoscopy diagnosis and pathological results and provide reference for the effective diagnosis and treatment of CAG in clinic. Methods 126 cases of CAG patients admitted and treated in our hospital from January 2014 to December 2016 were conveniently selected and all patients were given the pathological diagnosis， and the features of CAG under the endoscopy were observed and the CAG endoscopy results and pathological diagnosis results were compared and the diagnosis coincidence rate was calculated. Results 91 cases were diagnosed by the pathological examination of the 126 cases， and the CAG coincidence rate of endoscopy diagnosis was 72.2%， and there were 45 cases with intestinal metaplasia， accounting for 49.5%， 28 cases with dysplastic epithelium (30.8%)， and the CAG diagnosis rate of patients whose endoscopic mucosal feature was I type +II type +III type was obviously higher than that of patients whose endoscopic mucosal feature was I type and I type + II type (92.9% vs 33.3%， 71.4%)， and the differences were statistically significant(P<0.05). Conclusion The endoscopy shows that the vascular penetration and gastric mucosa white is the main， roughness with granular hyperplasia is highly consistent with the CAG pathological diagnosis， which can provide a certain value for the clinical accurate diagnosis of CAG and the combined use of the two can better improve the diagnosis accurate rate， and it is worth clinical promotion.
[Key words] Chronic atrophic gastritis； Endoscopy； Pathological diagnosis； Correlation
慢性萎縮性胃炎(CAG)是以胃粘膜上皮萎缩、固有腺体数目减少甚至消失为特征的的一类慢性胃炎，常并发肠上皮化生和不典型增生，是目前临床已经证实的一种癌前病变，因此需加强CAG早期诊治，以预防胃癌进展，改善预后[1]。胃粘膜活检是CAG临床诊断金标准，近年来，随着内镜技术的研发与推广，内镜监测随访在CAG诊断和早期胃癌检查中发挥了重要作用，文章现以2014年1月—2016年12月该院收治的126例内镜诊断为CAG的患者为例对内镜下CAG特征表现及其与病理诊断的符合情况进行分析和探讨，现报道如下。
1 资料与方法, 百拇医药(章再军 田祖成)