幽门螺杆菌相关性胃炎与胃癌胃大部切除术后患者胃体黏膜上皮不典型增生

目的研究幽门螺杆菌(Hp)感染及胃癌胃大部切除与胃体黏膜上皮不典型增生(GED)的关系。方法采用组织病理学的方法测定了20例慢性萎缩性胃炎和20例胃癌胃大部切除术后患者胃体GED情况。Hp的测定采用1min快速尿素酶法14C呼气试验法。结果(1)20例胃大部切除术后患者中,12例存在轻度～中度胃体GED,占60%;20例慢性胃炎中,7例存在轻度胃体GED,占35%。2组之间差异有显著性(P<005)。(2)在10例Hp相关性慢性胃炎中,6例存在轻度胃体GED,占60%;在10例慢性胃炎无Hp感染中,只有1例存在轻度胃体GED,占10%;2组之间差异有显著性(P<005)。(3)在10例胃大部切除术后合并Hp感染的患者中,8例存在轻度～中度胃体GED,占80%;在10例胃大部切除术后未合并Hp感染的患者中,4例存在轻度的胃体GED,占40%,2组之间差异有显著性(P<005)。结论胃大部切除术后和Hp感染患者,胃体GED发生率增加,发生恶变的发生率更高。

Gastric epithelial dysplasia in patients with Helicobacter pylori associated gastritis and after partial gastroectomy

Objective To study the relationship between Helicobacter pylori(Hp) infection,partial gastroectomy and gastric epithelial dysplasia (GED) of corpus.Methods Histopathological methods were used to measre corpus GED in 20 patients with chronic gastritis and 20 patients after partial gastroectomy.Hp infection was measured using 1 minute rapid urease method and~14 C breathe test.Results (1)12 out of 20 patients after partial garoectomy had mild tomoderate corpus GED,occupying 60% and 7 out of 20 patients with chronic gastritis of intace stomach had mild corpus GED,occupying 35%.The two groups showed a significant difference (P<0.05).(2)6 out of 10 patients with chronic gastritis of intace stomach complicated with Hp infection had corpus GED,occupying 60%,and in 10 patients with chronic gastritis onf intace stomach uncomplicated with Hp infection,there was only one patient who had mild corpus GED,occupying 10%.The two groups also showed a significant difference (P<0.05).(3)8 out of 10 patients after partial gastroectomy complicated with Hp infection had mild to moderate corpus GED, occupying 80%,while in 10 patients after partial gastroectomy uncomplicated with Hp infection, there were 4 patients who had mild corpus GED, occupying 40%,a significant difference (P<0.05).Conclusions The above results suggested that corpuss GED be increased in patients with Hp infection and these patients might have higher risk to undergo malignant changes.Hp infection and partial gastroctomy had a synergistic effect on the tendency of malignant change.