【摘要】 背景:目前对胃息肉的研究远不及结肠息肉,胃息肉与癌变以及幽门螺杆菌(H.pylori)感染的关系存在较多争议。目的:总结胃息肉的临床病理特征,并分析不同类型胃息肉与癌变和H.pylori感染的关系。方法:回顾性分析北京大学第三医院2003年1月～2008年12月经病理检查证实的胃息肉患者,分析不同类型胃息肉与肠化生、异型增生和癌变以及H.pylori感染的关系。结果:共检出1825例胃息肉患者,检出率4.3%。男女之比为1:2.3,66.3%为单发性息肉;胃底腺息肉、增生性息肉、腺瘤性息肉、炎性息肉和并发息肉(2种息肉同时发生于同一病例)分别占62.5%、32.2%、0.8%、1.7%和2.8%。贲门、胃底体和胃窦是增生性息肉较常见的发生部位。增生性息肉肠化生率和异型增生率均显著高于胃底腺息肉(5.3%对0.2%,7.2%对0.4%,P<0.001)。2例增生性息肉发生癌变,癌变率0.3%。增生性息肉H.pylori感染率显著高于胃底腺息肉(36.5%对8.0%,P<0.001)。结论:胃息肉检出率较低,以胃底腺和增生性息肉多见,并发息肉并非罕见。增生性息肉的肠化生率、异型增生率和H.pylori感染率均高于胃底腺息肉,且其可发生癌变。增生性息肉的发生可能与H.pylori感染有关。更多还原

【Abstract】 Background:Studies on gastric polyps are less profound than those on colonic polyps,the relevance of gastric polyps with malignant transformation and Helicobacter pylori(H.pylori) infection are still in debate.Aims:To summarize the clinicopathologic characteristics of gastric polyps,and to investigate the relevance of different histological types of gastric polyps with malignant transformation and H.pylori infection.Methods:The gastric polyp patients proved pathologically in Peking University Third Hospital from January 2003 to December 2008 were reviewed retrospectively. The relevance of different histological types of gastric polyps with intestinal metaplasia,dysplasia,malignant transformation and H.pylori infection were analyzed.Results:The detection rate of gastric polyps was 4.3%(1825 cases),including fundic gland polyps(62.5%),hyperplastic polyps(32.2%),adenomatous polyps(0.8%),inflammatory polyps(1.7%) and coincident polyps(two types of polyps found in one case)(2.8%).The ratio of male to female was 1:2.3,and 66.3%was solitary polyps.The cardia,fundus and antrum were the sites where hyperplastic polyps mainly located.The rates of intestinal metaplasia and dysplasia in hyperplastic polyps were significantly higher than those in fundic gland polyps(5.3%vs.0.2%;7.2%vs.0.4%,P<0.001).Two cases of cancer were found in hyperplastic polyps,the malignant transformation rate was 0.3%.H.pylori infection rate in hyperplastic polyps was significantly higher than that in fundic gland polyps(36.5%vs.8.0%,P<0.001).Conclusions:The detection rate of gastric polyps is low,and the majority are fundic gland polyps and hyperplastic polyps,coincident polyps is not rare.The rates of intestinal metaplasia,dysplasia and H.pylori infection in hyperplastic polyps are higher than those in fundic gland polyps,and malignant transformation is present in hyperplastic polyps.The occurrence of hyperplastic polyps may be related to H.pylori infection.更多还原