Palacios Salas Fernando, Frisancho Velarde Oscar, Palomino Portilla Eugenio
Departamento de Enfermedades del Aparato Digestivo, Hospital Nacional Edgardo Rebagliati Marins, EsSalud, Lima - Perú.
Rev Gastroenterol Peru. 2003 Oct-Dec;23(4):245-53.
Gastric polyps are elevated epithelial lesions which pathogenesis and natural history are not well known. The purpose of this study was to determine the association between gastric polyps and histological changes of the surrounding mucosa.
Prospective, descriptive and transversal study. From 6603 patients examined through upper endoscopy at the National Hospital Edgardo Rebagliati Marins (Lima-Peru) from January 2002 to May 2003,115 gastric polyps were detected (1.74%) 68 of which were included in this study. Gastric polyps were examined through endoscopy and thereafter excised, taking biopsies of the surrounding mucosa. The histological examination established the gastric polyp type and the presence of inflammation, activity (infiltration with polymorphonuclears), atrophy, metaplasia, and Helicobacter pylori in the surrounding mucosa.
Frequency of gastric polyps was as follows: hyperplastic: 51 (75%) adenomatous: 11 (16.2%) of fundic glands: 4 (5.9%) and inflammatory: 2 (2.9%). The mucosa surrounding hyperplastic polyps was characterized by the statistically significant presence of inflammation (100%, p=0.0001) and activity (84.3%, p=0.001) while the mucosa surrounding the adenomatous polyps showed statistically significant presence of inflammation (100%, p=0.0001) activity (81.8%, p=0.001), atrophy (72.7%, p=0.017) and metaplasia (72.7%, p=0.017). The severity of atrophy and metaplasia was significantly higher in the mucosa surrounding adenomatous polyps than in that surrounding hyperplastic polyps (p=0.019 and p=0.001).
Hyperplastic polyps are associated with the presence of inflammation and activity in the surrounding mucosa, whereas adenomatous polyps are associated with the presence of inflammation, activity, atrophy, and metaplasia in the surrounding mucosa. Atrophy and metaplasia were more severe in the mucosa surrounding adenomatous polyps.
胃息肉是一种隆起性上皮病变，其发病机制和自然病程尚不明确。本研究旨在确定胃息肉与周围黏膜组织学改变之间的关联。
前瞻性、描述性横断面研究。在2002年1月至2003年5月期间，对秘鲁利马埃加尔多·雷瓦利亚蒂·马林斯国家医院接受上消化道内镜检查的6603例患者进行检查，共检测出115例胃息肉（1.74%），其中68例纳入本研究。通过内镜检查胃息肉，随后将其切除，并取周围黏膜组织进行活检。组织学检查确定胃息肉类型以及周围黏膜中炎症、活动性（多形核白细胞浸润）、萎缩、化生和幽门螺杆菌的存在情况。
胃息肉的发生频率如下：增生性：51例（75%）；腺瘤性：11例（16.2%）；胃底腺性：4例（5.9%）；炎性：2例（2.9%）。增生性息肉周围黏膜的特征为炎症（100%，p=0.0001）和活动性（84.3%，p=0.001）的存在具有统计学意义，而腺瘤性息肉周围黏膜的炎症（100%，p=0.0001）、活动性（81.8%，p=0.001）、萎缩（72.7%，p=0.017）和化生（72.7%，p=0.017）的存在具有统计学意义。腺瘤性息肉周围黏膜的萎缩和化生严重程度显著高于增生性息肉周围黏膜（p=0.019和p=0.001）。
增生性息肉与周围黏膜炎症和活动性的存在相关，而腺瘤性息肉与周围黏膜炎症、活动性、萎缩和化生的存在相关。腺瘤性息肉周围黏膜的萎缩和化生更为严重。
