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目的：进一步研究胃溃疡癌变的学说及胃溃疡癌变的组织学基础。方法：对８１例胃溃疡（ＧＵ）随访３～１０ａ，定期行胃镜检查并做活检；对胃镜、手术证实的１０例胃溃疡癌变病例做回顾性分析，观察溃疡边缘组织和癌变周围组织的病理形态学特征。结果：８１例胃溃疡癌变３例（癌变率为３７％），癌变发生在溃疡边缘伴有明显萎缩、肠化和非典型增生（背景病变）的ＧＵ．１０例癌变胃溃疡（恶性溃疡）组织形态上与慢性胃溃疡相似，而与溃疡型胃癌不同，多是早期胃癌，甚至是粘膜内癌。恶性溃疡边缘均有明显萎缩、肠化和非典型增生。结论：ＧＵ癌变实质上是溃疡合并的粘膜萎缩、肠化和非典型增生的癌变、对背景病变有萎缩、肠化和非典型增生的ＧＵ需定期随访，可发现更多早期胃癌，并强调临床除对ＧＵ治疗外，应同时治疗其背景病变，对预防ＧＵ癌变，有十分重要的临床意义。
Objective: To further study the theory of gastric ulcer carcinogenesis and histological basis of gastric ulcer carcinogenesis. Methods: Eighty-one patients with gastric ulcer (GU) were followed up for 3 ~ 10 years. Gastroscopy and biopsy were performed on a regular basis. Ten patients with gastric ulcer confirmed by endoscopy and operation were retrospectively analyzed. The pathological changes of marginal and ulcerated tissues were observed Morphological characteristics. Results: 81 cases of gastric ulcer carcinogenesis in 3 cases (cancer rate was 3 7%), carcinogenesis occurred in the edge of the ulcer accompanied by atrophy, intestinal metaplasia and atypical hyperplasia (GU). Ten cases of cancerous gastric ulcer (malignant ulcer) morphology and chronic gastric ulcer similar, but different from the ulcer type gastric cancer, mostly early gastric cancer, and even mucosal cancer. Peripheral malignant ulcers were significantly atrophy, intestinal metaplasia and atypical hyperplasia. Conclusions: GU canceration is essentially carcinomatous mucosal atrophy, intestinal metaplasia and atypical hyperplasia associated with ulceration. GU patients with background atrophy, intestinal metaplasia and atypical hyperplasia need regular follow-up to find more early gastric cancer and emphasize clinical In addition to the treatment of GU, should be treated at the same time the background lesions, prevention of GU canceration, a very important clinical significance.