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目的：研究大肠粘膜抗原（ＬＩＭＡ），小肠粘膜抗原（ＳＩＭＡ）在良恶性胃病及异型增生胃粘膜中的表达及其临床意义。方法：对经病理证实的胃癌５７例、良性胃病４９例，采用免疫组化标记法进行ＬＩＭＡ、ＳＩＭＡ检测，并与常规粘液组化（ＨＩＤ）法检测结果相比较；另对良性胃病组中伴有粘膜异型增生者进行５年以上跟踪随访。结果：ＬＩＭＡ抗原在良恶性病变组间差异有显著性（Ｐ＜０．０５）；胃粘膜异型增生程度与ＬＩＭＡ抗原表达呈正相关；随访５年以上在胃粘膜发生癌变的２８例中，ＬＩＭＡ阳性率显著高于ＳＩＭＡ、ＨＩＤ（Ｐ＜０．０５）。结论：ＬＩＭＡ阳性的肠化生病变与ＬＩＭＡ阳性的异型增生胃粘膜（ＬＩＤ）在细胞形态上有过渡关系，前者是更早的癌前病变，后者则更接近细胞癌变过程；而ＳＩＭＡ阳性标记提示为小肠型化生，与癌变关系不大。
OBJECTIVE: To study the expression and clinical significance of large intestinal mucosal antigen (LIMA) and small intestinal mucosal antigen (SIMA) in benign and malignant gastric diseases and dysplastic gastric mucosa. Methods: 57 cases of gastric cancer and 49 cases of benign gastropathy confirmed by pathology were detected by LIMA and SIMA by immunohistochemical method, and compared with the results of routine mucohistochemistry (HID) method; Patients with mucosal dysplasia were followed up for more than 5 years. Results: There was significant difference in LIMA antigen between benign and malignant lesions (P<0.05). The degree of dysplasia in gastric mucosa was positively correlated with the expression of LIMA antigen. In the 28 patients with gastric cancer who were followed up for more than 5 years, LIMA was positive. The rate was significantly higher than that of SIMA and HID (P<0.05). Conclusions: LIMA-positive intestinal metaplasia has a transitional relationship with LIMA-positive dysplasia of gastric mucosa (LID). The former is an earlier precancerous lesion, and the latter is closer to the cell-cancerous process; SIMA-positive markers. Tips for small intestinal metaplasia have little to do with canceration.