Bajtai A, Hidvégi J, Figus I A, Szentirmay Z, Papp I, Kralovánszky J, Vitéz A
Patológiai Osztály, Fövárosi Uzsoki u. Kórház.
Orv Hetil. 1992 Aug 30;133(35):2227-32.
The stomach cancer develops on dysplastic lesions of gastric mucosa. It can be found in every precancerous condition, as chronic gastritis, gastric adenoma, giant rugal hypertrophy, chronic peptic ulcer, gastric stump after partial resection, pernicious anaemia. So, this dysplastic change is not a specific lesion. Different classifications are known for grading of gastric dysplasia. Authors evaluated them compared with each other. The signs of dysplasia were studied in 306 gastric aimed biopsy specimens from 233 patients between 1979-1990. In this material severe dysplasia occurred in 20.6%. It means a frequency of 0.84% regarding all gastric endoscopies in the same period of time. The endoscopic investigation revealed a protruded lesion in 18.5% and excavated one in 45.9%. What is very important, local change could not be detected in 35.6%. Follow-up study could be performed in 49 patients in a period of 1-7 years. In this group cancer developed in five patients. By the other hand, 22 gastric carcinomas were proved amongst 233 patients. The authors' recommendation is to follow-up the patients bearing gastric dysplasia at least during 10 years after the diagnosis.
胃癌发生于胃黏膜的发育异常病变。在每种癌前病变中都可发现,如慢性胃炎、胃腺瘤、巨大皱襞肥厚、慢性消化性溃疡、部分切除术后的胃残端、恶性贫血。所以,这种发育异常改变并非特异性病变。已知有不同的分类用于胃发育异常的分级。作者对它们进行了相互比较评估。在1979年至1990年间,对233例患者的306份胃靶向活检标本中的发育异常征象进行了研究。在该材料中,重度发育异常发生率为20.6%。这意味着在同一时期所有胃镜检查中的发生率为0.84%。内镜检查显示突出性病变占18.5%,凹陷性病变占45.9%。非常重要的是,35.6%的病例未检测到局部改变。49例患者进行了为期1至7年的随访研究。该组中有5例发生了癌症。另一方面,在233例患者中证实有22例胃癌。作者建议,对诊断为胃发育异常的患者至少随访10年。