Martínez-Madrigal F, Ortiz-Hidalgo C, Torres-Vega C, Alvarez L, Manzo-Montaño A, García-López L, Esquivel-Ayanegui F
Centro de Investigación Biomédica del Estado de Michoacán y Departamento de Anatomía Patológica, Hospital Regional de Zona No. 1, IMSS, Av. Hérves de Nocupétaro S/N Morelia, Mich., C.P. 58000.
Rev Gastroenterol Mex. 2000 Jan-Mar;65(1):11-7.
In the present work we study the association between chronic active gastritis (CAG), atypical regeneration and dysplasia and gastric Helicobacter pylori (HP) infection. We study two groups of endoscopic biopsies. Regenerative changes and dysplasia were evaluated according to Gandur-Maymneh et al. classification which was simplified in typical and atypical regeneration, and mild and severe dysplasia. The group I included 94 patients with CAG, 9 with chronic non active gastritis (CNAG) and 2 with normal gastric mucosa. CAG was graded according to activity in; severe 28 patients; moderate 54 patients and; mild 12 patients. HP association in these cases was 100%, 77% and 25%. In cases of CNAG HP was present in 22%, there were not HP in normal gastric mucosa. There were atypical regeneration in 25% of moderate CAG and in 42% of severe CAG. Mild dysplasia was present in 7.5 and 25% in cases of moderate and severe CAG. Two biopsies showed severe dysplasia. In addition, intestinal metaplasia was found in 15% of CAG, the metaplasia was present in 25% of cases with CAG and atypical regeneration; in 54% of cases with mild dysplasia and; in 100% on cases with severe dysplasia. The group II included 9 cases of gastric cancer of intestinal type, 7 cases of diffuse type, and 4 cases of mixed type. In all these cases there was viewed CAG associated to HP infection in non-neoplastic mucosa. In 75% of cases there were showed atypical regeneration and 60% presented some type of dysplasia. There was transition between atypical regeneration and dysplasia in 6 cases of intestinal gastric cancer and in 3 cases of mixed type. We found relationship between the intensity of CAG and HP colonization, and the association with atypical regeneration and dysplasia.
在本研究中，我们探讨慢性活动性胃炎（CAG）、异型增生与发育异常和胃幽门螺杆菌（HP）感染之间的关联。我们研究了两组内镜活检样本。根据Gandur - Maymneh等人的分类标准评估再生变化和发育异常，该分类在典型和非典型再生以及轻度和重度发育异常方面进行了简化。第一组包括94例CAG患者、9例慢性非活动性胃炎（CNAG）患者和2例胃黏膜正常的患者。CAG根据活动程度分级为：重度28例；中度54例；轻度12例。这些病例中HP的关联率分别为100%、77%和25%。在CNAG病例中，HP的存在率为22%，胃黏膜正常的病例中未检测到HP。中度CAG中有25%出现非典型再生，重度CAG中有42%出现非典型再生。轻度发育异常在中度和重度CAG病例中的发生率分别为7.5%和25%。两份活检样本显示为重度发育异常。此外，15%的CAG病例中发现肠化生，在伴有CAG和非典型再生的病例中，肠化生的发生率为25%；轻度发育异常病例中的发生率为54%；重度发育异常病例中的发生率为100%。第二组包括9例肠型胃癌、7例弥漫型胃癌和4例混合型胃癌。在所有这些病例中，在非肿瘤性黏膜中均观察到与HP感染相关的CAG。75%的病例出现非典型再生，60%出现某种类型的发育异常。在6例肠型胃癌和3例混合型胃癌中，非典型再生和发育异常之间存在过渡。我们发现CAG的严重程度与HP定植之间存在关联，以及与非典型再生和发育异常之间的关联。
