摘要
目的探讨复查胃镜的中年人群上消化道疾病的内镜及病理学特征,为临床诊治提供依据。方法回顾性分析2015年1月1日至2020年12月31日在北京中医药大学东方医院胃镜中心复查电子胃镜的中年人群,收集其性别、胃镜诊断、病理结果及H.pylori结果等数据,对首查及复查结果进行分析比较。结果共有397例年龄为35~55岁复查胃镜的受检者,首次检查中慢性萎缩性胃炎、胃溃疡、胃息肉、十二指肠溃疡、食管溃疡、胃癌例数分别为:86例(21.66%)、49例(12.34%)、73例(18.38%)、41例(10.33%)、5例(1.26%)、2例(0.50%),复查例数分别为:93例(23.43%)、19例(4.79%)、89例(22.42%)、20例(5.04%)、1例(0.25%)、1例(0.25%),其中复查胃溃疡、十二指肠溃疡检出率低于首查,差异有统计学意义(P<0.05)。十二指肠溃疡、胃息肉的例数在性别分布上差异有统计学意义(P<0.05),H.pylori阳性例数首查、复查分别为:264例(88.29%)、161例(78.92%),差异有统计学意义(P<0.05)。慢性萎缩性胃炎、胃溃疡、胃息肉中H.pylori阳性例数高于阴性例数,差异有统计学意义(P<0.05)。胃癌前病变首查例数为215例,复查为250例,其中首查胃黏膜萎缩、肠上皮化生、异型增生、上皮内瘤变检出例数分别为:86例(21.66%)、205例(51.64%)、45例(11.34%)、42例(10.58%),复查分别为:93例(23.43%)、226例(56.93%)、89例(22.42%)、37例(9.32%),复查异型增生检出率高于首查(P<0.05)。癌前病变发病部位在胃窦、胃角、胃体、贲门、幽门的分布,差异有统计学意义(P<0.05),以胃窦、胃角最为常见。两次检查癌前病变的H.pylori阳性例数高于H.pylori阴性例数,差异有统计学意义(P<0.05)。结论复查胃镜的中年人群中慢性萎缩性胃炎、胃息肉及H.pylori阳性检出率较高;癌前病变中肠上皮化生检出率最高,而异型增生例数复查增加最多;癌前病变部位以胃窦、胃角最为常见。
Objective To investigate the endoscopic and pathological features of upper gastrointestinal diseases in middle-aged population who had underwent gastroscopy to provide a basis for clinical diagnosis and treatment.Methods A retrospective analysis of the middle-aged people who reviewed electronic gastroscopy in our hospital from Jan.1st,2015 to Dec.31st,2020,collected data on their gender,gastroscopy diagnosis,pathological results,and H.pylori results,and performed the first and re-examination results analyse and compare.Results There were a total of 397 patients aged from 35 to 55 years old who had underwent gastroscopy.The numbers of chronic atrophic gastritis,gastric ulcer,gastric polyp,duodenal ulcer,esophageal ulcer,and gastric cancer during the first examination were 86 cases(21.66%),49 cases(12.34%),73 cases(18.38%),41 cases(10.33%),5 cases(1.26%),2 cases(0.50%),the numbers of re-examination cases were 93 cases(23.43%),19 cases(4.79%),89 cases(22.42%),20 cases(5.04%),1 case(0.25%),1 case(0.25%).The detection rate of gastric ulcer duodenal ulcer in re-examination was lower than that in the first examination,and the difference was statistically significant(P<0.05).The number of duodenal ulcer and gastric polyp was different in gender distribution(P<0.05).The numbers of H.pylori positive in the first examination and re-examination were:264 cases(88.29%)and 161 cases(78.92%),and the difference was statistically significant(P<0.05).The numbers of H.pylori positive in chronic atrophic gastritis,gastric ulcer,gastric polyps,and duodenal ulcer were higher than those of negative ones,and the difference was statistically significant(P<0.05).The number of first cases of gastric precancerous lesions was 215,and the number of re-examination was 250.Among them,the detection cases of gastric mucosal atrophy,intestinal metaplasia,dysplasia,and intraepithelial neoplasia during the first examination were 86 cases(21.66%),205 cases(51.64%),45 cases(11.34%),42 cases(10.58%),re-examination were:93 cases(23.43%),226 cases(56.93%),89 cases(22.42%),37 cases(9.32%),the detection rate of dysplasia in the re-examination was higher than that in the first examination(P<0.05).The distribution of precancerous lesions in gastric antrum,gastric horn,gastric body,cardia and pylorus were different(P<0.05),and the gastric antrum and gastric horn were the most common.The number of H.pylori-positive cases of precancerous lesions in the two examinations was higher than the number of H.pylori-negative cases,and the difference was statistically significant(P<0.05).Conclusion The positive detection rates of chronic atrophic gastritis,gastric polyps and H.pylori in the middle-aged population who rechecked gastroscopy are higher;the precancerous lesion has the highest detection rate of midgut epithelial metaplasia,while the number of dysplasia cases increases the most;the antrum and angle of the stomach are the most common.
作者
袁文玲
张立平
王林恒
王允亮
陈润花
姚玉璞
YUAN Wenling;ZHANG Liping;WANG Linheng;WANG Yunliang;CHEN Runhua;YAO Yupu(Beijing University of Chinese Medicine,Beijing 100029;Department of Gastroenterology,Dongfang Hospital of Beijing University of Chinese Medicine,China)
出处
《胃肠病学和肝病学杂志》
CAS
2021年第11期1264-1269,共6页
Chinese Journal of Gastroenterology and Hepatology
关键词
胃镜检查
回顾性研究
病理检查
癌前病变
Gastroscopy
Retrospective study
Pathological examination
Precancerous lesions
