Kim Sunjin, Ito Masanori, Haruma Ken, Egi Yasuo, Ueda Hiroyuki, Tanaka Shinji, Chayama Kazuaki
Department of Medicine and Molecular Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
J Gastroenterol Hepatol. 2006 May;21(5):837-41. doi: 10.1111/j.1440-1746.2006.04193.x.
Recent studies have demonstrated the diagnostic potential of magnifying endoscopy in cases of histologic gastritis. The aim of the present study was to clarify whether the mucosal surface structure reflects the degree of histologic gastritis below the surface.
Gastric biopsy specimens were obtained from 1018 Japanese patients and were stained with hematoxylin and eosin. In 863 sections examined, gastritis was graded by means of the updated Sydney system, and the surface structure was classified as one of four types: flat, irregular, papillary, or non-structured. In addition, 103 patients underwent gastric examination by magnifying gastroscopy.
The surface structure of most biopsy sections with normal mucosa and no Helicobacter pylori infection was classified as the flat type. Grades of histological gastritis were statistically lower in flat-type sections than in other types. Histologic gastritis was found in 91% of sections with a non-flat surface structure. Helicobacter pylori infection was confirmed in 96% of these cases. Most biopsy sections in patients with abnormal magnifying endoscopy features were of the non-flat type and showed histologic gastritis.
The surface structure of the gastric mucosa reflects the status of histologic gastritis. Magnifying gastroscopy could be a useful non-invasive method of diagnosing histologic gastritis.
最近的研究已经证明了放大内镜在组织学胃炎病例中的诊断潜力。本研究的目的是阐明黏膜表面结构是否反映了表面以下组织学胃炎的程度。
从1018名日本患者中获取胃活检标本，并用苏木精和伊红染色。在检查的863个切片中，采用更新的悉尼系统对胃炎进行分级，表面结构分为四种类型之一：扁平型、不规则型、乳头型或无结构型。此外，103名患者接受了放大胃镜检查。
大多数黏膜正常且无幽门螺杆菌感染的活检切片的表面结构被分类为扁平型。扁平型切片的组织学胃炎分级在统计学上低于其他类型。在表面结构非扁平型的切片中，91%发现有组织学胃炎。在这些病例中，96%证实有幽门螺杆菌感染。放大内镜特征异常的患者的大多数活检切片为非扁平型，并显示有组织学胃炎。
胃黏膜的表面结构反映了组织学胃炎的状况。放大胃镜检查可能是诊断组织学胃炎的一种有用的非侵入性方法。
