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目的分析胃镜下表现为胃食管贲门糜烂性病变的病理组织学改变,指导胃镜下取活检指征,探讨貌似糜烂性炎性病变是否均必须作病理组织学检查。方法回顾性总结2005年我院胃镜下诊断为食管胃中~重度糜烂性病变247例所作的病理组织学诊断,部分结合手术后病理。分析其与年龄、病变部位及内镜下表现之间的关系。结果247例中,浅表性炎94例;含有癌前病变者(萎缩、肠上皮化生或不典型增生)123例;癌30例(早期癌23例)。其中癌及癌前病变占61·9%(153/247例)。45岁以上者癌及癌前病变占68·6%,55~65岁之间癌检出率最高(22·6%)。结论提示无论患者年龄大小及病变部位不同最好均要做病理组织学检查。尤其是要重视55~65岁之间、病变位于高位胃体以上的患者。
Objective To analyze the histopathological changes of gastroesophageal and gastric cardia erosive lesions under endoscopy, and to guide the biopsy indications under gastroscope to explore whether all seemingly erosive inflammatory lesions must be histopathologically examined. Methods The histopathological diagnosis of 247 cases diagnosed as esophageal ~ severe erosive lesions by gastroscopy in our hospital in 2005 was retrospectively reviewed, and some of them were combined with postoperative pathology. Analysis of its relationship with age, lesion location and endoscopic performance. Results There were 94 cases of superficial inflammation in 247 cases, 123 cases of precancerous lesions (atrophy, intestinal metaplasia or atypical hyperplasia), and 30 cases of carcinoma (early stage carcinoma in 23 cases). Including cancer and precancerous lesions accounted for 61.9% (153/247 cases). Cancer over 45 years old and precancerous lesions accounted for 68.6%, 55 to 65 years old the highest detection rate of cancer (22.6%). Conclusions suggest that regardless of age and size of patients with different lesions are best to do the pathological examination. In particular, we should pay attention to 55 to 65 years old, patients with lesions above the upper corpus.