内镜检查中胃贲门部肠上皮化生的研究

目的　了解内镜检查中贲门部肠上皮化生的发病情况 ,探讨其临床、内镜及病理学特点。方法　对 12 0例行常规上消化道内镜检查的患者自食管末端、贲门部及胃窦取活检 ,经HE、AB PAS、AB HID及Giemsa染色行病理组织学检查。结果　 12 0例中 2 6例 (2 1.7% )在贲门部检出肠上皮化生 ,与年龄、胃黏膜萎缩及炎症相关 (P <0 .0 5 ,P <0 .0 1)。黏液组织化学染色显示完全肠化 17例 (14 .2 % ) ,不完全肠化 9例 (7.5 % )。完全肠化与贲门炎、HP感染以及胃窦肠化发生率密切相关 (P <0 .0 5 )。结论　贲门部肠上皮化生的发生较Barrett食管肠化相对常见 ,随年龄增长其发生率明显增加 ,与贲门炎症关系密切 ,完全肠化可能与幽门螺杆菌相关性胃炎以及胃内多处萎缩肠化有关

Cardia intestinal metaplasia in patients undergoing diagnostic gastroscopy

Objective To investigate the prevalence and clinical presentation, endoscopic aspect and gastric histology of cardia intestinal metaplasia (CIM). Methods Biopsy specimens were taken from the 120 randomly selected patients undergoing routine diagnostic endoscopy. Eight biopsy specimens, taken from cardia, lower esophagus and gastric antrum, were stained with hematoxylin/eosin, alcian blue/periodic acid-Schiff, alcian blue/high iron diamine and Gimenez, respectively. Results CIM was found in 26 patients (21.67%), which was associated with increased age, atrophic gastritis and inflammation (P< 0.05, P< 0.01). Complete CIM was detected in 17 (14.2%) of the 120 subjects, and incomplete CIM subtype in 9 (7.5%). There was association of complete IM with carditis, H.pylori infection and antral intestinal metaplasia (P< 0.05). Conclusion CIM is more common than Barrett's esophagus and increases in prevalence with age. Complete CIM is a manifestation of H.pylori infection associated with gastritis and multifocal atrophic gastritis.