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慢性萎缩性胃炎组织病理学表现与内镜检查结果的差异性分析OACSTPCD

Analysis of differences between histopathological findings and endoscopic examination results in chronic atrophic gastritis

中文摘要英文摘要

目的:部分患者的组织病理学表现符合慢性萎缩性胃炎,而相应的内镜检查却没有报告慢性萎缩性胃炎.本研究拟将组织病理学表现符合萎缩和肠化生的患者作为研究的目标人群,探讨这部分人群的临床特征、病理结果与内镜检查的符合率,并对其进行差异性分析.方法:收集2011年1月至2020年12月在湘雅三医院和长沙市中心医院就诊的慢性萎缩性胃炎的胃镜检查和病理诊断的结果.根据病理学检查结果与内镜检查结果将患者分为相符组和不符组,比较2组临床特征、病理学检查与内镜检查的差异.结果:研究纳入病理符合慢性萎缩性胃炎患者2446例,其中男1472例(60.2%),胃窦萎缩者1829例(74.8%),伴有肠化生者1806例(73.8%).病理学检查与内镜检查的诊断符合率为87.0%.相符组与不相符组在病变部位的分布上有差异(P<0.001).在年龄<60岁的人群中,不相符组的年龄较相符组更年轻[分别为(47.6±8.8)和(49.9±7.2)岁,P<0.001].结论:慢性萎缩性胃炎男性较为多见,萎缩部位主要位于胃窦,大多数患者伴有肠化生.病理学检查与内镜检查结果不相符的情况在非胃窦部位和相对年轻的患者中更为常见.

Objective:Some patients exhibit histopathological features of chronic atrophic gastritis that are not reported in corresponding endoscopic examinations.This study aims to investigate the clinical characteristics,pathological results,and the concordance rate with endoscopic findings in patients with histopathological evidence of atrophy and intestinal metaplasia,and to analyze the differences. Methods:The study collected data from January 2011 to December 2020 on gastroscopy and pathological diagnoses of chronic atrophic gastritis from the Third Xiangya Hospital and Changsha Central Hospital.Patients were divided into concordant and discordant groups based on the agreement between pathological and endoscopic results.Clinical characteristics,pathological findings,and differences in endoscopic results were compared between the 2 groups. Results:The study included 2446 patients with histopathological evidence of chronic atrophic gastritis,including 1472 males(60.2%),1829 cases(74.8%)with antral atrophy,and 1806 cases(73.8%)with intestinal metaplasia.The concordance rate between pathological and endoscopic diagnoses was 87.0%.There were differences in the distribution of lesions between the concordant and discordant groups(P<0.001).Among patients under 60 years old,the discordant groups had a younger age compared to the concordant group[(47.6±8.8)years vs(49.9±7.2)years,P<0.001]. Conclusion:Chronic atrophic gastritis is more common in males,with atrophy mainly located in the antrum and most patients exhibiting intestinal metaplasia.Discrepancies between pathological and endoscopic findings are more frequent in non-antral regions and younger patients.

贺祥凤;曹烁;彭依;罗举

长沙市中心医院老年医学科,长沙 410004中南大学湘雅三医院消化内科,长沙 410013

慢性萎缩性胃炎组织病理学内镜检查萎缩肠化生

chronic atrophic gastritishistopathologyendoscopic examinationatrophyintestinal metaplasia

《临床与病理杂志》 2024 (005)

674-680 / 7

长沙市中心医院科研项目(YNKY202401).This work was supported by the Science Project of Changsha Central Hospital,China(YNKY202401).

10.11817/j.issn.2095-6959.2024.240206

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