自身免疫性胃炎患者不典型增生和早期胃癌的临床和形态学特征

A. S. Tertychnyy, N. V. Pachuashvili, D. P. Nagornaya, T. L. Lapina, E. A. Losik, A. B. Ponomarev, P. V. Pavlov, A. P. Kiryukhin, A. A. Fedorenko, D. D. Protsenko, V. T. Ivashkin
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引用次数: 0

摘要

А im:分析自身免疫性胃炎(AIG)患者发生的一系列不典型增生和早期胃癌的病例,探讨其临床和形态学特征。材料和方法。本研究包括6例在AIG背景下发现的早期胃癌。6例患者中有4例接受了内镜治疗,6例患者中有3例接受了内镜粘膜切除术并剥离粘膜下层。1例患者于2017年接受内窥镜手术,每年进行动态随访,无肿瘤复发迹象。1型神经内分泌肿瘤和轻度发育不良的女性患者正在等待治疗。结果。在6例AIG患者中,有5例病变定位于胃体,而所有检测到的肿瘤都是早期肿瘤,并且根据胃型的免疫表型。本病例的肿瘤不伴有神经内分泌细胞的增生,直接在肿瘤本身的区域,但仅在周围的胃粘膜。此外,还发现了几例早期胃肠道间质瘤,其特点是增殖活性低,体积小。结论。假幽门化生在周围粘膜中的优势使我们认为假幽门化生可能是AIG患者胃粘膜的一个潜在的显著变化,可能先于胃癌的发展。
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Clinical and Morphological Features of Dysplasia and Early Gastric Cancer in the Patients with Autoimmune Gastritis
А im: to analyze a series of cases of dysplasia and early gastric cancer developed in patients with autoimmune gastritis (AIG), and to identify their clinical and morphological features. Materials and methods. The study included six cases of detection of early gastric cancer on the background of AIG. Four out of six patients underwent endoscopic treatment, and in three out of six cases patients underwent endoscopic mucosectomy with dissection in the submucosal layer. One patient underwent endoscopic surgery in 2017, he continues annual dynamic follow-up without signs of tumour recurrence. A female patient with type 1 neuroendocrine tumour and mild dysplasia is awaiting treatment. Results. In five out of six patients with AIG, the localization of lesions prevailed in the stomach body, while all detected tumours were early ones, and according to the immunophenotype — of a gastric type. The presented cases of tumours were not accompanied by hyperplasia of neuroendocrine cells directly in the area of the tumour itself, but only in the surrounding gastric mucosa. Additionally, several cases of early gastrointestinal stromal tumours were found, which were characterized by low proliferative activity and had small sizes. Conclusion. The predominance of pseudopyloric metaplasia in the surrounding mucosa allows us to consider pseudopyloric metaplasia as a potentially significant change in the gastric mucosa of patients with AIG that may precede the development of gastric cancer.
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来源期刊
CiteScore
1.90
自引率
0.00%
发文量
44
审稿时长
8 weeks
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