Spigelman A D, Williams C B, Talbot I C, Domizio P, Phillips R K
St. Mark's Hospital, London.
Lancet. 1989 Sep 30;2(8666):783-5. doi: 10.1016/s0140-6736(89)90840-4.
102 patients with familial adenomatous polyposis underwent upper gastrointestinal endoscopy as a screening test for gastroduodenal adenomas. 100 had duodenal abnormalities (dysplasia in 94, and hyperplasia in 6), usually in the second and third parts of the duodenum (91%). The periampullary area was abnormal in 87 of 97 patients who had a biopsy specimen taken from this site (dysplasia 72, hyperplasia 13, and inflammation 2). By contrast, gastric dysplasia was found in only 6 patients. Classification of duodenal polyposis on a 5-grade scale (stages 0-IV), based on polyp number, size, histology, and severity of dysplasia, showed that 11 had stage IV disease: these patients are at greatest risk of malignant change and require close surveillance. The pattern of dysplasia observed in the upper gastrointestinal tract resembled the pattern of mucosal exposure to bile.
102例家族性腺瘤性息肉病患者接受了上消化道内镜检查，作为胃十二指肠腺瘤的筛查试验。100例有十二指肠异常（94例发育异常，6例增生），通常位于十二指肠第二和第三部分（91%）。在97例从壶腹周围区域取活检标本的患者中，87例该区域异常（发育异常72例，增生13例，炎症2例）。相比之下，仅6例患者发现胃发育异常。根据息肉数量、大小、组织学和发育异常严重程度，将十二指肠息肉病分为5级（0-IV期），结果显示11例为IV期疾病：这些患者发生恶变的风险最高，需要密切监测。上消化道观察到的发育异常模式与黏膜暴露于胆汁的模式相似。
