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目的:研究早期胃癌微血管形态变化以及Bcl-2和P53在早期胃癌中的表达特点。方法:选取245例消化不良症状的住院患者,首先用放大内镜观察胃微血管形态,然后根据胃小凹状况分为A、B、C、D、E型,分别检测不同胃小凹分型标本中Bcl-2和P53阳性率。结果:浅表性胃炎主要见于A型(57.9%)、B型(49.0%)和c型(20.0%)小凹类型;萎缩性主要见于C型(40.0%)和D型(50.0%);肠上皮化生主要见于C型(32.0%)、D型(35.7%)和E型36.0%);不典型增生多见于D型(10.7%)和E型(34.0%);胃癌仅见于E型(14.0%)。不同类型的微血管形态,其Bcl-2和P53阳性率比较,差异有统计学意义。E型小凹的标本中Bcl-2和P53阳性率分别为68.0%与62.0%,均显著高于A(5.2%与7.8%)、B(7.8%与11.8%)、C(18.0%与16.0%)、D型(26.8%与30.4%),差异有统计学意义;D型小凹的标本中Bcl-2和P53阳性率均显著高于B型,差异亦有统计学意义。结论:早期胃癌及癌前病变主要发生在D、E型小凹类型;微血管形态可作为早期胃癌的诊断指标,放大内镜可以作为早期胃癌诊断的一种临床筛选方法。
Objective: To study the morphological changes of microvessels in early gastric cancer and the expression of Bcl-2 and P53 in early gastric cancer. Methods: Forty-five inpatients with dyspeptic symptoms were enrolled in this study. First, the morphology of gastric microvessels was observed by magnifying endoscopy, and then classified into A, B, C, D, In Bcl-2 and P53 positive rate. Results: The main types of superficial gastritis were found in type A (57.9%), type B (49.0%) and type C (20.0%). The atrophy was mainly found in type C (40.0%) and type D The incidence of intestinal metaplasia was mainly seen in type C (32.0%), type D (35.7%) and type E (36.0%). Atypical hyperplasia was more common in type D (10.7%) and type E (14.0%). Different types of microvascular morphology, the positive rate of Bcl-2 and P53, the difference was statistically significant. The positive rates of Bcl-2 and P53 in specimens of type E were 68.0% and 62.0% respectively, which were significantly higher than those of A (5.2% and 7.8%), B (7.8% and 11.8%), C %), D type (26.8% and 30.4%), the difference was statistically significant. The positive rates of Bcl-2 and P53 in D-shaped fossa were significantly higher than those in B type, the difference was also statistically significant. Conclusion: Early gastric cancer and precancerous lesions mainly occur in type D and E concave. Microvascular morphology can be used as a diagnostic indicator of early gastric cancer. Magnifying endoscopy can be used as a clinical screening method for the diagnosis of early gastric cancer.