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目的研究早期贲门癌在体内的发生规律。方法在食管癌高发现场建立前瞻性研究队列(106人),定期普查,利用内镜检查的方法,前后对照式地观察贲门癌高发位点贲门脊根部粘膜变化情况,在相同区域咬取相同块数的活检组织。活检组织经中性福尔马林液固定,常规脱水,石蜡包埋,切片,HE染色,做病理学检查。结果4年后,本组106人,8例贲门粘膜正常者,3例正常,4例出现慢性胃炎,1例发生粘膜内癌;61例慢性胃炎,11例出现腺上皮萎缩,4例发生腺上皮轻度不典型增生,2例腺上皮高度不典型增生;9例腺上皮萎缩病例,5例无变化,4例变为慢性胃炎;22例腺上皮轻度不典型增生,17例消退,4例无变化,1例进展为腺上皮高度不典型增生;1例腺上皮高度不典型增生变为轻度不典型增生;5例未经任何治疗的粘膜内癌,1例成为浸润癌,1例仍为早期癌,3例变为贲门粘膜轻度不典型增生。结论早期贲门癌发生经历慢性胃炎、腺上皮萎缩、不典型增生几个癌前阶段;早期贲门癌和癌前病变在体内处于动态的可复性的变化过程中。
Objective To study the occurrence of early cardiac cancer in vivo. Methods A prospective cohort of 106 patients with esophageal cancer at a high incidence site was established. Periodic census and endoscopic examination were performed to observe the change of mucosa in the cardia and spinal cord at the high incidence site of cardia cancer before and after. The same area Number of biopsies. The biopsy tissue was fixed in neutral formalin, routinely dehydrated, embedded in paraffin, sectioned and stained with HE for pathological examination. Results 4 years later, the group of 106 people, 8 cases of cardia mucosa was normal, 3 cases were normal, 4 cases of chronic gastritis, mucosal carcinomas occurred in 1 case; 61 cases of chronic gastritis, 11 cases of glandular epithelial atrophy, 4 cases of glandular gland Mild hyperplasia of epithelium, 2 cases of atypical hyperplasia of glandular epithelium; 9 cases of glandular epithelial atrophy, 5 cases of no change, 4 cases of chronic gastritis; 22 cases of mild dysplasia of glandular epithelium, 17 cases regressed, 4 One case progressed to atypical hyperplasia of glandular epithelium; one case of atypical hyperplasia of glandular epithelium became mild dysplasia; 5 cases of mucosal carcinoma without any treatment, one case of invasive carcinoma and one case of invasive carcinoma Still early cancer, 3 cases of cardia mucosa mild atypical hyperplasia. Conclusions Early gastric cardia carcinoma undergoes several precancerous stages of chronic gastritis, glandular epithelial atrophy, and atypical hyperplasia. Early cardia carcinoma and precancerous lesions are dynamically and reversibly changed in vivo.