Misra S P, Dwivedi M, Misra V, Agarwal S K, Gupta R, Gupta S C, Mital V P
Department of Gastroenterology and Pathology, Medical College, Allahabad, India.
Gastrointest Endosc. 1990 Nov-Dec;36(6):575-9. doi: 10.1016/s0016-5107(90)71167-4.
To assess reliability of the endoscopic and histologic appearance of the gastric mucosa for diagnosing portal hypertension, 50 patients with portal hypertension and 1323 controls were studied. Endoscopic evidence of mild gastritis was seen more frequently in patients with portal hypertension than in the control group (42% vs. 13.1%, p less than 0.001). The mosaic sign was also seen more frequently in patients with portal hypertension compared with controls (14% vs. 0.9%, p less than 0.001). However, the mosaic sign was found to be nonspecific, and the sensitivity for diagnosis of portal hypertension was only 14%. Biopsy specimens from the stomach of all patients with portal hypertension and 100 controls with a normal endoscopic appearance revealed mucosal vascular congestion in 72% of patients with portal hypertension compared with 59% of controls (NS). There was no correlation between endoscopic and histologic evidence of congestive gastropathy. Similarly, there was no correlation between the severity of mucosal vascular congestion and the degree of inflammatory changes observed in the biopsy specimens; both in the control (r = 0.1) and in patients with portal hypertension (r = 0.14). It is concluded that endoscopic and histologic features of the gastric mucosa in patients with portal hypertension are of low sensitivity and nonspecific and cannot be used to diagnose portal hypertension.
为评估胃黏膜的内镜及组织学表现对诊断门静脉高压的可靠性，对50例门静脉高压患者和1323例对照者进行了研究。门静脉高压患者中出现轻度胃炎的内镜证据比对照组更常见（42% 对13.1%，p<0.001）。与对照组相比，门静脉高压患者中出现马赛克征的情况也更常见（14% 对0.9%，p<0.001）。然而，发现马赛克征不具有特异性，其诊断门静脉高压的敏感性仅为14%。对所有门静脉高压患者及100例内镜表现正常的对照者的胃活检标本显示，门静脉高压患者中有72%出现黏膜血管充血，而对照组为59%（无显著性差异）。充血性胃病的内镜和组织学证据之间无相关性。同样，活检标本中观察到的黏膜血管充血严重程度与炎症变化程度之间也无相关性；对照组（r = 0.1）和门静脉高压患者组（r = 0.14）均如此。结论是，门静脉高压患者胃黏膜的内镜和组织学特征敏感性低且不具有特异性，不能用于诊断门静脉高压。
