Owen D A
Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.
Yale J Biol Med. 1996 Jan-Feb;69(1):51-60.
Gastritis is a histopathologic diagnosis, which correlates poorly with both clinical symptoms of non-ulcer dyspepsia and endoscopic abnormalities. Worldwide, most cases of gastritis are due to Helicobacter pylori and are characterized by a diffuse superficial antral gastritis. Chronic inflammatory cells and lymphoid follicles are present in the lamina propria. Neutrophils are present in the surface and pit-lining epithelium. In North America and Western Europe, reactive gastropathy due to duodenal reflux or non-steroidal anti-inflammatory agents is also common. In this condition, there is no increase in inflammatory cells, but the pit-lining cells become hyperplastic, and the pits have a corkscrew appearance. Most examples of multifocal atrophic gastritis are the result of long standing Helicobacter gastritis, although there may be other causes as well. It is characterized by loss of glands in both pyloric and corpus mucosae with intestinal metaplasia of the surface epithelium. A subtype of intestinal metaplasia, in which sulphomucin (large bowel mucin) is present, has been associated with the development of distal gastric cancer. However, this association is relatively weak and is not considered useful for screening purposes. Gastric dysplasia may develop in areas of the stomach affected by intestinal metaplasia. High-grade dysplasia is a significant finding, with up to 60 percent of cases having coincident carcinoma and a further 25 percent of cases likely to develop an invasive malignancy within fifteen months.
胃炎是一种组织病理学诊断，与非溃疡性消化不良的临床症状和内镜异常的相关性都很差。在全球范围内，大多数胃炎病例是由幽门螺杆菌引起的，其特征为弥漫性浅表性胃窦炎。固有层中存在慢性炎症细胞和淋巴滤泡。中性粒细胞存在于表面和腺窝衬里上皮中。在北美和西欧，由十二指肠反流或非甾体类抗炎药引起的反应性胃病也很常见。在这种情况下，炎症细胞没有增加，但腺窝衬里细胞增生，腺窝呈螺旋状外观。多灶性萎缩性胃炎的大多数病例是长期幽门螺杆菌胃炎的结果，不过也可能有其他原因。其特征是幽门和胃体黏膜中的腺体丧失，表面上皮出现肠化生。存在硫酸黏液素（大肠黏液素）的一种肠化生亚型与远端胃癌的发生有关。然而，这种关联相对较弱，不被认为对筛查有帮助。胃发育异常可能在受肠化生影响的胃区域发生。高级别发育异常是一个重要发现，高达60%的病例同时患有癌症，另有25%的病例可能在15个月内发展为浸润性恶性肿瘤。
