胃内常见隆起性病变
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摘要
胃内隆起性病变是胃镜检查过程中常见的病变,根据病变来源可分为黏膜组织来源、黏膜下组织来源及外源性压迫。常见胃黏膜组织来源病变有增生性息肉、胃底腺息肉、腺瘤等,黏膜下组织来源病变有胃肠道间质瘤、异位胰腺、脂肪瘤、胃囊肿、炎性纤维性息肉、胃肠道平滑肌瘤等,可统称为胃黏膜下肿瘤;外源性压迫有肝肿大、肝癌、胃壁外的脏器等所致。胃内隆起性病变临床表现缺乏特异性,其中胃底腺息肉、胃腺瘤、胃肠道间质瘤等病变具有恶变潜能。随着人们的饮食结构的改变、健康意识的提高及电子胃镜的广泛应用,胃内隆起性病变检出率及治愈率明显提高,对预防胃癌发生、发现早期胃癌和治疗早期胃癌有重要的临床意义。
Gastric protruding lesions are common during digestive endoscopic examination.According to the origin of lesions,they can be divided into mucosal layer derived,submucosal layer derived and extrinsic compression caused. Common mucosal originated lesions include hyperplastic polyps,gastric fundus polyps,gastric adenoma. Submucosal tissue originated lesions include gastrointestinal stromal tumors,ectopic pancreas,lipoma,gastric cysts,inflammatory fibrous polyps,which can be collectively referred to submucosal tumors. The extrinsic compression lesions may due to hepatomegaly,hepatocarcinoma and adjacent organs. Gastric protruding lesions are lack of significant clinical manifestations,however lesions like fundic gland polyps,gastric adenoma,gastrointestinal stromal tumors and some other lesions have malignant potential. Changing in people's diet,health awareness with the popularization of endoscopic examination,the detection rate and cure rate of gastric protruding lesions have dramatically improved,which lead to a better prevention of gastric cancer and early treatment of gastric cancer.
Gastric protruding lesions are common during digestive endoscopic examination.According to the origin of lesions,they can be divided into mucosal layer derived,submucosal layer derived and extrinsic compression caused. Common mucosal originated lesions include hyperplastic polyps,gastric fundus polyps,gastric adenoma. Submucosal tissue originated lesions include gastrointestinal stromal tumors,ectopic pancreas,lipoma,gastric cysts,inflammatory fibrous polyps,which can be collectively referred to submucosal tumors. The extrinsic compression lesions may due to hepatomegaly,hepatocarcinoma and adjacent organs. Gastric protruding lesions are lack of significant clinical manifestations,however lesions like fundic gland polyps,gastric adenoma,gastrointestinal stromal tumors and some other lesions have malignant potential. Changing in people's diet,health awareness with the popularization of endoscopic examination,the detection rate and cure rate of gastric protruding lesions have dramatically improved,which lead to a better prevention of gastric cancer and early treatment of gastric cancer.
引文
1芳野纯治,浜田勉,川口实.内镜诊断与鉴别诊断图谱.上消化道[M].沈阳:辽宁科学技术出版社,2014.
2 Bone GE,Mc Clelland RN.Management of gastric polyps[J].Surg Gynecol Obstet,1976,142(6):933-938.
3 Park DY,Lauwers GY.Gastric polyps:classification and management[J].Arch Pathol Lab Med,2008,132(4):633-640.
4 Elster K.Histologic classification of gastric polyps[J].Curr Top Pathol,1976,63(24):77-93.
5 Vatansever S,Alper E,Ekinci N.Gastric polyps and polypoid lesions:Retrospective analysis of 36650 endoscopic procedures in29940 patients[J].Turk J Gastroenterol,2015,26(2):117-122.
6 Stolte M,Sticht T,Eidt S,et al.Frequency,location,and age and sex distribution of various types of gastric polyp[J].Endoscopy,1994,26(8):659.
7 杨雪,李易,李贞茂,等.胃底腺息肉与胃增生性息肉特点的分析与比较[J].四川医学,2016,37(6):605-608.
8 Carmack SW,Genta RM,Schule CM,et al.The current spectrum of gastric polyps:a 1-year national study of over 120,000 patients[J].Am J Gastroenterol,2009,104(6):1524-1532.
9 Cao H,Wang B,Zhang Z,et al.Distribution trends of gastric polyps:an endoscopy database analysis of 24 121 northern Chinese patients[J].J Gastroenterol Hepatol,2012,27(7):1175-1180.
10 Torbenson M,Lee JH,Cruz-Correa M,et al.Sporadic fundic gland polyposis:a clinical,histological,and molecular analysis[J].Mod Pathol,2002,15(7):718-723.
11 Hofgartner WT,Thorp M,Ramus MW,.Gastric adenocarcinoma associated with fundic gland polyps in a patient with attenuated familial adenomatous polyposis[J].Am J Gastroenterol,1999,94(8):2275-2281.
12 Zwick A,Munir M,Ryan CK,et al.Gastric adenocarcinoma and dysplasia in fundic gland polyps of a patient with attenuated adenomatous polyposis coli[J].Gastroenterology,1997,113(2):659-663.
13 Bertoni G,Sassatelli R,Nigrisoli E,et al.Dysplastic changes in gastric fundic gland polyps of patients with familial adenomatous polyposis[J].Ital J Gastroenterol Hepatol,1999,31(3):192.
14 郭广英,姜瑞勤,邢建华,等.140例胃底腺息肉临床分析[J].内蒙古医学杂志,2014,46(3):328-330.
15 Jung A,Vieth M,Maier O,et al.Fundic gland polyps(Elster's cysts)of the gastric mucosa.A marker for colorectal epithelial neoplasia?[J].Pathol Res Pract,2002,198(11):731-734.
16 Jalving M,Koornstra J J,Wesseling J,et al.Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy[J].Aliment Pharmacol Ther,2006,24(9):1341–1348.
17 Abraham SC,Singh VK,Yardley JH,et al.Hyperplastic polyps of the stomach:associations with histologic patterns of gastritis and gastric atrophy[J].Am J Surg Pathol,2001,25(4):500-507.
18 Lim SA,Yun JW,Yoon D,et al.Regression of Hyperplastic Gastric Polyp after Helicobacter pylori Eradication[J].Korean J Gastrointest Endosc,2011,42(2):74-82.
19 Abraham SC,Park SJ,Lee JH,et al.Genetic Alterations in Gastric Adenomas of Intestinal and Foveolar Phenotypes[J].Mod Pathol,2003,16(8):786-795.
20 Abraham SC,Montgomery EA,Singh VK,et al.Gastric adenomas:intestinal-type and gastric-type adenomas differ in the risk of adenocarcinoma and presence of background mucosal pathology[J].Am J Surg Pathol,2002,26(10):1276-1285.
21 Kobayashi N,Saito YT.Treatment strategy for laterally spreading tumors in Japan:before and after the introduction of endoscopic submucosal dissection[J].J Gastroenterol Hepatol,2009,24(8):1387-1392.
22 令狐恩强,韩英.胃肠诊断图谱[M].沈阳:辽宁科学技术出版社,2016.
23 小山恒男.胃癌ESD术前诊断[M].沈阳:辽宁科学技术出版社,2015.
24 Yamamoto T,Imakiire K,Hashiguchi S,et al.A rare case of gastric lipoma with early gastric cancer[J].Int Med,2004,43(11):1039.
25 Vanek J.Gastric submucosal granuloma with eosinophilic infiltration[J].Am J Pathol,1949,25(3):397.
26 周晓军,樊祥山.解读2010年消化系统肿瘤WHO分类(Ⅱ)[J].临床与实验病理学杂志,2011,27(7):341-346.
27 许良璧,项一宁.胃肠道炎性纤维性息肉的内镜诊断与治疗[J].世界华人消化杂志,2014,22(35):5550-5555.
28 Caplin ME,Buscombe JR,Hilson AJ,et al.Carcinoid tumour[J].Lancet,1998,352(9130):799-805.
29 Rindi G,Luinetti O,Cornaggia M,et al.Three subtypes of gastric argyrophil carcinoid and the gastric neuroendocrine carcinoma:a clinicopathologic study[J].Gastroenterology,1993,104(4):994-1006.
2 Bone GE,Mc Clelland RN.Management of gastric polyps[J].Surg Gynecol Obstet,1976,142(6):933-938.
3 Park DY,Lauwers GY.Gastric polyps:classification and management[J].Arch Pathol Lab Med,2008,132(4):633-640.
4 Elster K.Histologic classification of gastric polyps[J].Curr Top Pathol,1976,63(24):77-93.
5 Vatansever S,Alper E,Ekinci N.Gastric polyps and polypoid lesions:Retrospective analysis of 36650 endoscopic procedures in29940 patients[J].Turk J Gastroenterol,2015,26(2):117-122.
6 Stolte M,Sticht T,Eidt S,et al.Frequency,location,and age and sex distribution of various types of gastric polyp[J].Endoscopy,1994,26(8):659.
7 杨雪,李易,李贞茂,等.胃底腺息肉与胃增生性息肉特点的分析与比较[J].四川医学,2016,37(6):605-608.
8 Carmack SW,Genta RM,Schule CM,et al.The current spectrum of gastric polyps:a 1-year national study of over 120,000 patients[J].Am J Gastroenterol,2009,104(6):1524-1532.
9 Cao H,Wang B,Zhang Z,et al.Distribution trends of gastric polyps:an endoscopy database analysis of 24 121 northern Chinese patients[J].J Gastroenterol Hepatol,2012,27(7):1175-1180.
10 Torbenson M,Lee JH,Cruz-Correa M,et al.Sporadic fundic gland polyposis:a clinical,histological,and molecular analysis[J].Mod Pathol,2002,15(7):718-723.
11 Hofgartner WT,Thorp M,Ramus MW,.Gastric adenocarcinoma associated with fundic gland polyps in a patient with attenuated familial adenomatous polyposis[J].Am J Gastroenterol,1999,94(8):2275-2281.
12 Zwick A,Munir M,Ryan CK,et al.Gastric adenocarcinoma and dysplasia in fundic gland polyps of a patient with attenuated adenomatous polyposis coli[J].Gastroenterology,1997,113(2):659-663.
13 Bertoni G,Sassatelli R,Nigrisoli E,et al.Dysplastic changes in gastric fundic gland polyps of patients with familial adenomatous polyposis[J].Ital J Gastroenterol Hepatol,1999,31(3):192.
14 郭广英,姜瑞勤,邢建华,等.140例胃底腺息肉临床分析[J].内蒙古医学杂志,2014,46(3):328-330.
15 Jung A,Vieth M,Maier O,et al.Fundic gland polyps(Elster's cysts)of the gastric mucosa.A marker for colorectal epithelial neoplasia?[J].Pathol Res Pract,2002,198(11):731-734.
16 Jalving M,Koornstra J J,Wesseling J,et al.Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy[J].Aliment Pharmacol Ther,2006,24(9):1341–1348.
17 Abraham SC,Singh VK,Yardley JH,et al.Hyperplastic polyps of the stomach:associations with histologic patterns of gastritis and gastric atrophy[J].Am J Surg Pathol,2001,25(4):500-507.
18 Lim SA,Yun JW,Yoon D,et al.Regression of Hyperplastic Gastric Polyp after Helicobacter pylori Eradication[J].Korean J Gastrointest Endosc,2011,42(2):74-82.
19 Abraham SC,Park SJ,Lee JH,et al.Genetic Alterations in Gastric Adenomas of Intestinal and Foveolar Phenotypes[J].Mod Pathol,2003,16(8):786-795.
20 Abraham SC,Montgomery EA,Singh VK,et al.Gastric adenomas:intestinal-type and gastric-type adenomas differ in the risk of adenocarcinoma and presence of background mucosal pathology[J].Am J Surg Pathol,2002,26(10):1276-1285.
21 Kobayashi N,Saito YT.Treatment strategy for laterally spreading tumors in Japan:before and after the introduction of endoscopic submucosal dissection[J].J Gastroenterol Hepatol,2009,24(8):1387-1392.
22 令狐恩强,韩英.胃肠诊断图谱[M].沈阳:辽宁科学技术出版社,2016.
23 小山恒男.胃癌ESD术前诊断[M].沈阳:辽宁科学技术出版社,2015.
24 Yamamoto T,Imakiire K,Hashiguchi S,et al.A rare case of gastric lipoma with early gastric cancer[J].Int Med,2004,43(11):1039.
25 Vanek J.Gastric submucosal granuloma with eosinophilic infiltration[J].Am J Pathol,1949,25(3):397.
26 周晓军,樊祥山.解读2010年消化系统肿瘤WHO分类(Ⅱ)[J].临床与实验病理学杂志,2011,27(7):341-346.
27 许良璧,项一宁.胃肠道炎性纤维性息肉的内镜诊断与治疗[J].世界华人消化杂志,2014,22(35):5550-5555.
28 Caplin ME,Buscombe JR,Hilson AJ,et al.Carcinoid tumour[J].Lancet,1998,352(9130):799-805.
29 Rindi G,Luinetti O,Cornaggia M,et al.Three subtypes of gastric argyrophil carcinoid and the gastric neuroendocrine carcinoma:a clinicopathologic study[J].Gastroenterology,1993,104(4):994-1006.