Frazzetta M, Raimondo D, Furgiuele G, Sammartano A, Romito F, Frazzetta F, Lucania M, Piccolo C Lo, Bonventre S
Department of Surgical and Oncological Sciences, University of Palermo, Italy.
G Chir. 2010 Apr;31(4):162-6.
The Authors report the results of their experience on polypoids lesions of the stomach and on endoscopic polypectomies.
A study on 2000 OGD (oesophagogastroduodenoscopy) has been carried out on 95 patients with polypoid lesions. The authors have analysed the associations existing between histological type and symptomatology and localisation of the lesion and the status of the Helicobacter pylori and the risk of cancerization. The data were confronted with the ones already available.
In the majority of the cases, the polypoid lesions were asymptomatic, the localization changed according to the histological type, with the antrum as the most affected area. The presence of Helicobacter pylori does not seem to be correlated to the lesion, except in the case of hyperplastic polyps. The percentage of risks of cancerization increased in case of adenomatous polyps. In one patient signet ring cell carcinoma within a gastric polyp was found. Gastric signet ring cell carcinomas are peculiar for their rarity as well as for the growth in polypoid lesions.
We confirm the higher frequency of hyperplastic polyps and the correlation between histological type and localization. Endoscopic polipectomy is the first approach in gastric polyps, with lower risk of developing cancer. Only in selected cases, as in one in ours, it is advisable the surgery.
作者报告了他们在胃息肉样病变及内镜下息肉切除术方面的经验结果。
对95例有息肉样病变的患者进行了2000次食管胃十二指肠镜检查(OGD)研究。作者分析了组织学类型与症状、病变部位以及幽门螺杆菌状态之间存在的关联,以及癌变风险。将这些数据与已有的数据进行了对比。
在大多数病例中,息肉样病变无症状,病变部位根据组织学类型而变化,胃窦是受影响最严重的区域。幽门螺杆菌的存在似乎与病变无关,增生性息肉除外。腺瘤性息肉的癌变风险百分比增加。在一名患者的胃息肉中发现了印戒细胞癌。胃印戒细胞癌因其罕见以及在息肉样病变中的生长情况而独具特点。
我们证实了增生性息肉的较高发生率以及组织学类型与部位之间的相关性。内镜下息肉切除术是胃息肉的首选方法,癌变风险较低。仅在特定病例中,如我们研究中的一例,手术是可取的。