早期胃癌的胃镜检查与病理特征

Jianjun Lyu, Y. Qiao, S. Yan, Ruirui Zhang
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摘要

目的探讨经胃镜诊断的早期胃癌的胃镜检查及病理特点。方法随机选取2015年8月至2018年12月侯马市人民医院收治的80例早期胃癌患者。所有患者均行胃镜检查,参照胃癌临床诊断标准和日本内镜学会早期胃癌分类标准进行镜下评估,取出病变组织进行病理检查,参照病理分类标准进行分型。结果80例早期胃癌患者以腹痛以上临床症状为主要表现(71例,占88.75%),其次为恶心、呕吐、上消化道出血。显微分类类型依次为Ⅱ型(32例,占40.00%)、III型(27例,占33.75%)、I型(21例,占26.25%),病变位置由高到低依次为胃窦(68例,占85.00%)、(52例,占65.00%)、胃角(41例,占51.5%)、心脏(29例,占36.25%)。早期胃癌最常见的病理特征是乳头状腺癌(31例,占38.75%),其次是高分化管状腺癌、中分化腺癌、低分化腺癌、粘液腺癌和印戒细胞癌。结论早期胃癌临床症状不典型。在胃镜下更容易定位病变和类型。胃镜下标本的病理结果可以明确胃癌的性质。关键词:胃癌;胃镜检查;乳头状腺癌
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Gastroscopy and pathological features of early gastric cancer
Objective To investigate the gastroscopy and pathological features of early gastric cancer diagnosed by gastroscope. Methods Eighty patients with early gastric cancer admitted to Houma People’s Hospital from August 2015 to December 2018 were randomly selected. All patients underwent gastroscopic, and were evaluated microscopically with reference to the clinical diagnosis criteria for gastric cancer and the classification criteria for early gastric cancer classification of the Japanese Endoscopic Society, the lesion tissue for pathological examination was extracted, and referred to the pathological classification criteria for typing. Results The 80 patients with early gastric cancer had abdominal pain above clinical symptoms (71 cases, accounting for 88.75%) as their main manifestation, followed by nausea, vomiting, and upper gastrointestinal bleeding. The type of microscopic classification was high in order from type Ⅱ (32, accounting for 40.00%), type III (27 cases, accounting for 33.75%), type I (21 cases, accounting for 26.25%), the position of the lesion from high to low was the gastric antrum (68 patients, accounting for 85.00%), (52 cases, accounting for 65.00%), gastric angle (41 cases, accounting for 51.5%), and cardiac (29 cases, accounting for 36.25%). Papillary adenocarcinoma was the most common pathological feature of early gastric cancer (31 cases, accounting for 38.75%), followed by highly differentiated tubular adenocarcinoma, moderately differentiated adenocarcinoma, poorly differentiated adenocarcinoma, mucinous adenocarcinoma, and signet ring cell carcinoma. Conclusions The clinical symptoms of early gastric cancer are atypical. It is easier to locate lesions and types under gastroscopy. The pathological results of specimens extracted under gastroscopy can clarify the nature of gastric cancer. Key words: Gastric cancer; Gastroscopy; Papillary adenocarcinoma
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