目的 探讨不同病理类型胃癌的内镜下形态变化规律。方法 应用电子胃镜行上消化道内镜检查,并在病灶部位活检。结果 确诊进展型胃癌486例,病理以腺癌多见,部位以胃窦部最多,其次是胃体,且以DorrmannⅢ型和Ⅱ型多见。结论 胃鳞癌一般表现为结节状或半球型隆起,表面有糜烂或出血坏死并与深大溃疡交错存在。恶性度较高的胃癌多不规则,广泛浸润。 Objective To investigate the endoscopic changes of gastric cancer in different pathological types. Methods Upper gastroscopic endoscopy was performed using an electronic gastroscope and a biopsy was performed at the lesion site. Results 486 patients with confirmed advanced gastric cancer were diagnosed. Adenocarcinoma was more common in the pathology, with most of the gastric antrum located at the site, followed by the corpus, more common with Dorrmann III and II. Conclusions Gastric squamous cell carcinoma generally presents as a nodular or hemispherical bulge with erosion or necrosis on the surface and is interlaced with deep ulcers. Highly malignant gastric cancers are more irregular and extensively infiltrated.