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目的:比较同卵、异卵双胞胎胃体、胃窦黏膜组织病理学变化,为进一步阐明遗传和环境因素对胃癌前病变和癌发生发展的影响提供依据。方法:对190对双胞胎(同卵双胞胎147对,异卵双胞胎43对)进行胃镜检查、胃黏膜活检及组织病理学检查。结果:组织病理学结果发现3对胃癌(1对双发,2对单发);27对不典型增生(胃体部2对均为单发,胃窦部3对双发,22对单发),一致率为11.1%(3/27);31对肠上皮化生(胃体部2对均为单发,胃窦部10对双发,19对单发),一致率为32.3%(10/31)。结论:双胞胎二位成员胃癌前病变和癌检出率低且明显不一致,提示环境因素在胃癌前病变和癌的发生发展中可能起主导作用。
OBJECTIVE: To compare the histopathological changes in gastric mucosa and gastric antrum mucosa of identical and dizygotic twins to provide a basis for further elucidating the effects of genetic and environmental factors on precancerous lesions and carcinogenesis. Methods: Gastroscopy, gastric mucosa biopsy, and histopathological examination were performed on 190 pairs of twins (147 identical pairs and 43 pairs of identical twins). RESULTS: Histopathological findings revealed 3 pairs of gastric cancer (1 pair of doubles, 2 pairs of singles); 27 pairs of dysplasia (2 pairs of gastric body were single, 3 pairs of doubled antrum, 22 pairs of single hair ), Concordance rate was 11.1% (3/27); 31 pairs of intestinal metaplasia (2 pairs of stomach body were single, gastric antrum 10 pairs of hair, 19 pairs of single), the agreement rate was 32.3% ( 10/31). Conclusion: The prevalence of gastric precancerous lesions and cancers in the two members of the twins are low and obviously inconsistent, suggesting that environmental factors may play a leading role in the development of precancerous lesions and carcinomas.