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目的:探讨贲门癌癌旁组织及无症状人群贲门黏膜活检组织肠上皮化生(IM)的分布特征。方法:采用艾显蓝-雪夫(AB-PAS)和高铁二胺-艾显兰(HID-AB)黏液组织化学染色法,对河南贲门癌高发区70例贲门癌癌旁组织和320例无症状人群贲门黏膜活检组织中的IM进行检测。结果:贲门癌癌旁组织的IM检出率38.5%(27/70),高于无症状人群贲门黏膜活检组织中的IM检出率4.4%(14/320)(χ2=71.3945,P<0.01)。贲门癌癌旁组织IM不完全型占92.6%(25/27),完全型IM占7.4%(2/27);无症状人群贲门黏膜的IM不完全型占7.1%(1/14),完全型IM占92.9%(13/14);2者比较,差异有统计学意义(χ2=29.0157,P<0.01)。贲门癌旁组织的IM大肠型占59.2%(16/27),小肠型占40.8%(11/27);无症状人群贲门黏膜的IM小肠型占92.9%(13/14),大肠型占7.1%(1/14);2者比较,差异有统计学意义(χ2=10.3173,P<0.01)。结论:IM可能是河南贲门癌高发区贲门癌癌前病变的一种重要表现形式;不完全型和大肠型IM可能是贲门癌前病变的独特组织学类型。
Objective: To investigate the distribution of intestinal metaplasia (IM) in gastric cardia cancer adjacent tissues and asymptomatic people. Methods: Seventy patients with cardia cancer adjacent tissues and 320 asymptomatic patients with cardia cancer in Henan Province were treated with AB-PAS and HID-AB mucinous histochemical staining. The population of gastric cardia mucosal biopsy IM test. Results: The detection rate of IM in gastric cancer tissue was 38.5% (27/70), which was higher than that in asymptomatic gastric cardia mucosa biopsy (4.4%, 14/320) (χ2 = 71.3945, P <0.01 ). Cardiac cancer adjacent tissue IM incomplete type accounted for 92.6% (25/27), complete IM accounted for 7.4% (2/27); asymptomatic population cardia mucosa IM incomplete accounted for 7.1% (1/14), complete Type IM accounted for 92.9% (13/14); 2, the difference was statistically significant (χ2 = 29.0157, P <0.01). There were 59.2% (16/27) cases of IM colorectal tissues and 40.8% (11/27) cases of gastric mucosa adjacent to gastric cardia tissues, 92.9% (13/14) cases of IM intestinal mucosa of asymptomatic group, and 7.1% % (1/14); 2, the difference was statistically significant (χ2 = 10.3173, P <0.01). Conclusions: IM may be an important manifestation of precancerous lesions of gastric cardia in the high incidence area of cardia cancer in Henan Province. Incomplete and large intestine type IM may be the unique histological type of precancerous lesions of cardia.