【摘要】 目的：进一步研究胃溃疡癌变的学说及胃溃疡癌变的组织学基础。方法：对８１例胃溃疡（ＧＵ）随访３～１０ａ，定期行胃镜检查并做活检；对胃镜、手术证实的１０例胃溃疡癌变病例做回顾性分析，观察溃疡边缘组织和癌变周围组织的病理形态学特征。结果：８１例胃溃疡癌变３例（癌变率为３７％），癌变发生在溃疡边缘伴有明显萎缩、肠化和非典型增生（背景病变）的ＧＵ．１０例癌变胃溃疡（恶性溃疡）组织形态上与慢性胃溃疡相似，而与溃疡型胃癌不同，多是早期胃癌，甚至是粘膜内癌。恶性溃疡边缘均有明显萎缩、肠化和非典型增生。结论：ＧＵ癌变实质上是溃疡合并的粘膜萎缩、肠化和非典型增生的癌变、对背景病变有萎缩、肠化和非典型增生的ＧＵ需定期随访，可发现更多早期胃癌，并强调临床除对ＧＵ治疗外，应同时治疗其背景病变，对预防ＧＵ癌变，有十分重要的临床意义。更多还原

【Abstract】 Objective:To study the theory and the histological testimony of canceration in gastric ulcer. Methods: 81 cases of GU were followed up in 3 to 10 years by endoscopy and biopsy. 10 cases of GU undergoing malignant change (malignant ulceration) were analysed pathobiologically. Results: Canceration of 81 cases of GU taked place in 3 cases of GU. Rate of canceration was 37%. Canceration appeared in adjacent mucosa of ulceration which was bound to follow atrophy, intestinal metaplasia (IM) and dysplasia (background diseases). 10 cases of malignant ulceration was similar with chronic gastric ulcer but not with ulcerating gastric cancer, and often early gastric cancer. Malignant ulceration presented with atrophy, IM and dysplasia. Conclusion: The canceration of GU is virtually that of atrophy, IM and dysplasia in border of GU. It would find more than early gastric cancer by following up GU that background diseases were atrophy, IM and dysplasia, and avoid GU canceration by treating background diseases.更多还原