【摘要】 目的：通过对胃恶性溃疡旁粘膜病变的Ｘ线－病理对照研究，旨在说明胃溃疡癌变存在的事实。材料与方法：对１８例胃恶性溃疡的１２２处胃切面，采用放射状象限取材对照法观察溃疡旁粘膜病变。结果：胃溃疡癌变溃疡病灶与周围交界面主要Ｘ线表现为小段弧形隆起，边缘较规则，杵状皱襞、纤细皱襞可达溃疡龛影的边缘或小段弧形隆起的边缘；溃疡旁Ｘ线表现以迂曲粗大皱襞及纤细条纹状皱襞为主，病理镜下改变是以慢性浅表性胃炎为主。溃疡型胃癌溃疡病灶与周围交界面主要Ｘ线表现为小带状无皱襞区，近溃疡侧的纤细不规则皱襞与远侧的杵状皱襞相接；溃疡旁Ｘ线表现是粘膜皱襞影像多较模糊，尤以模糊条纹状皱襞及模糊网格状伴有“靶征”居多，病理镜下改变是以慢性萎缩性胃炎、肠上皮化生及胃粘膜上皮异型增生等癌前病变为主。结论：胃溃疡癌变与溃疡型胃癌是两种病，胃溃疡癌变的存在亦是客观事实。同时鉴于癌组织有“潜掘式”浸润的特点，因此在Ｘ线判断病变的范围时应引起注意更多还原

【Abstract】 Objective: A patho-radiologic correlative study on periulcer mucosal changes of gastric malignant ulcers had been carried on in order to verify the fact that the canceration of the benign gastric ulcer does exist.Materials and Methods:122 radiant quadrant sections drawn from 18 cases of gastric malignant ulcers were used to observe the juxtaulcer mucosal changes comparing with radiological manifestation.Results:The main radiological manifestations of the interface of peripheral cancerized gastric ulcer are: Small segment with prominent, regular margin, clubbed plica, slim plicae reaching the margin of the niche or margin of the small segment of are prominent. The radiological presentations of gastric cancerized ulcers are mainly tortuous large plicea and slim striped plicae, and the pathologic changes under microscope are mainly chronic superficial gastritis. In gastric ulcerocancer, the main radiological changes of the interface are small teniform non-plicae area, the slim irregular plicae near the ulcer connecting with distal clubbed plicae. The juxta-ulcer presentation are instinct mucosal plicae, especially blurred teniform plicae and reticular plicae accompanying with “target sign” in most cases and the pathologic changes of peri-ulcer are chronic atrophic gastritis, intestinal epithelial metaplsia and epithelial heterotypic hyperplasia of gastric mucosal etc.Conclusion: The gastric ulcer canceration and gastric ulcerocancer are two different disease. The fact of canceration of benign ulcer does exist. When judging the extent of foci, more attention should be paid because of the “under cover digging” infiltration of the cancer.更多还原