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目的 通过对胃粘膜上皮异型增生（ｇａｓｔｒｉｃ ｅｐｉｔｈｅｌｉａｌ ｄｙｓｐｌａｓｉａ，ＧＥＤ）的内镜描述、病理组织学分级、不同治疗方法和癌变的回顾性研究，使内镜表现与组织学形态有机结合，为病理和临床医生制定规范统一的ＧＥＤ描述术语和诊断分级标准，为ＧＥＤ的治疗方法和预后判断提供客观依据。方法 选取５４例具有随访资料的ＧＥＤ病例，进行ＨＥ、Ｇｏｄｅｎ－Ｓｗｅｅｔ网染、Ｐ５３和ＣＥＡ免疫组化染色，观察内镜形态、组织学分级和治疗方法与癌变的关系。结果 高度ＧＥＤ内镜形态表现为褪色和灰白色，光泽消失，质地变硬且弹性差，呈平坦凹陷或平坦凸起伴浅表糜烂并且大于０．５ｃｍ，与癌变关系非常密切（Ｐ＜０．０５）。低度ＧＥＤ多为隆起型，与增生性息肉和萎缩性胃炎难鉴别。结论 低度异型增生（ｌｏｗ ｇｒａｄｅ ｄｙｓｐｌａｓｉａ）应当密切随访，或做内镜局部粘膜病灶切除后随访。高度异型增生应做内镜局部粘膜病灶切除或胃部分切除后密切随访。
Objective To retrospectively study the endoscopic features of gastric epithelial dysplasia (GED), histopathological grading, different treatment methods and carcinogenesis so as to combine the endoscopic findings with the histological morphology. Doctors to develop a standardized GED description terms and diagnostic grading standards for the GED treatment and prognosis to provide an objective basis. Methods 54 cases of GED with follow-up data were selected for HE staining, Goden-Sweet mesh staining, P53 and CEA immunohistochemical staining to observe the relationship between endoscopic morphology, histological grade, treatment and carcinogenesis. Results The appearance of high GED endoscopy was faded and grayish white, the gloss disappeared, the texture was hard and the elasticity was poor, flat or flat with shallow superficial erosion and greater than 0.5cm, which had a close relationship with carcinogenesis (P <0.05 ). Low GED mostly uplift type, and proliferative polyps and atrophic gastritis difficult to identify. Conclusion Low grade dysplasia should be followed up closely or endoscopically. Local mucosal lesions should be followed up. A high degree of dysplasia should be done endoscopic partial mucosal lesion resection or partial resection of the stomach close follow-up.