论文部分内容阅读
[目的]探讨可疑恶变巨大溃疡胃镜下中医微观辨证分型与胃癌MG7抗原(MG7-Ag)表达的关系及两者对良、恶性溃疡鉴别的辅助指导价值。[方法]对58例经首次胃镜检查、活检、病理未能确诊为胃癌的胃巨大溃疡患者进行镜下中医微观辨证分型,同时进行MG7-Ag,ABC免疫组化染色后,临床随访,随访时间1~72周(平均7周),所有患者均再次复查胃镜,组织活检,病理检查。[结果]MG7-Ag阳性表达在络灼伤阴型(18/19)与络阻热瘀型溃疡(8/10)中明显高于胃热型(2/14)与胃寒型(2/15)(P<0.01)。MG7-Ag阳性表达30例中有19例二次病理活检确诊为胃癌(63.3%),其中络灼伤阴型18例,络阻热瘀型1例;阴性表达28例中有5例确诊为胃癌(17.9%),其中络灼伤阴型1例,络阻热瘀型2例,胃热型与胃寒型各1例。其胃癌检出率在MG7-Ag阳性表达与阴性表达患者之间及不同辨证分型之间差异有统计学意义(P<0.01)。[结论]MG7-Ag阳性表达络灼伤阴型及络阻热瘀型胃巨大溃疡与胃癌关系密切,对这部分患者进行密切随访,有助于胃癌的早期发现。
[Objective] To explore the relationship between microscopic differentiation syndrome of gastric cancer and the expression of MG7 antigen (MG7-Ag) in patients with suspected malignant giant ulcer under endoscopy and the value of the two in assisting the identification of benign and malignant ulcers. [Method] 58 cases of giant gastric ulcer patients who were diagnosed as gastric cancer by first gastroscopy, biopsy and pathology were observed microscopically and microscopically under the microscope. After MG7-Ag and ABC immunohistochemical staining, the clinical follow-up and follow-up Time of 1 to 72 weeks (an average of 7 weeks), all patients were reviewed again endoscopy, biopsy, pathological examination. [Results] The positive expression of MG7-Ag in gastric ulcer (8/19) was significantly higher than that in gastric heat-type (2/14) and gastric-cold type ) (P <0.01). Among the 30 cases with MG7-Ag positive expression, 19 cases were diagnosed as secondary gastric biopsy by gastric biopsy (63.3%), of which 18 cases were negative collateral burns and 1 case was collateral-heat stasis type. 5 cases of negative expression were diagnosed as gastric cancer (17.9%). Among them, 1 was burned in the vagina, 2 was in the heat-stasis type and 1 in the stomach-type and stomach-cold type. The detection rate of gastric cancer was significantly different between patients with positive expression of MG7-Ag and those with negative expression (P <0.01). [Conclusion] The positive expression of MG7-Ag in the patients with gastric burns and gastric ulcer with collateral-heat-stasis syndrome is closely related to gastric cancer. Close follow-up of these patients is helpful for the early detection of gastric cancer.