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目的探讨放大内镜下溃疡边缘黏膜小凹形态及黏膜微血管等微细结构对胃良恶性溃疡的诊断价值。方法Pentax EG-3430Z型放大胃镜对158例溃疡病患者,先行常规检查,后利用其放大功能观察溃疡边缘胃小凹及黏膜微血管改变,于相应部位内镜下活检,行病理组织学检查。结果良性溃疡胃小凹形态规则,34．4％及67．7％患者呈C型和D型,93．8％恶性溃疡患者胃小凹呈E型,形态不规则,大小不一,良恶性溃疡小凹形态差异有统计学意义(X2=103．888,P<0．01);良性溃疡中,69．9％患者可见规则毛细血管网,恶性溃疡患者中,80％患者可见黏膜微血管不规则如迂曲、变形、融合等现象,29．2％的患者可见粗大的肿瘤血管,微血管形态差异有统计学意义(X2=130．963,P <0．01);黏膜小凹形态及微血管微细结构变化对恶性溃疡的诊断具有较高的灵敏性和特异性。结论放大内镜下胃小凹及黏膜微血管变化对良恶性溃疡的诊断、鉴别及早期胃癌的发现有重要意义。
Objective To explore the value of magnifying endoscopic mucosal pits and mucosal microvascular structures in the diagnosis of benign and malignant gastric ulcers. Methods Pentax EG-3430Z magnifying gastroscope for 158 cases of ulcer patients, first routine examination, after the use of its magnifying function to observe the ulcer gastric mucosa and mucosal microvascular changes in the corresponding endoscopic biopsy, histopathological examination. Results Benign ulcer gastric concave shape rules, 34.4% and 67.7% of patients were C and D, 93.8% of patients with malignant gastric ulcer was E-shaped, irregular shape, the size of different, benign and malignant There were significant differences in the morphology of ulcer (X2 = 103.888, P <0.01); in 69.9% of benign ulcers, regular capillary network was observed in 80% of patients with malignant ulcer 29.2% of the patients showed gross tumor vessels, the morphological differences of microvessels were statistically significant (χ2 = 130.963, P <0.01); the morphology of mucosal pits and the micro-capillary Structural changes in the diagnosis of malignant ulcers with high sensitivity and specificity. Conclusion The magnification of endoscopic small gastric recess and mucosal microvascular changes in the diagnosis of benign and malignant ulcers, identification and early gastric cancer is of great significance.