摘要
目的分析深在性囊性胃炎(GCP)的临床特征,提高对GCP的认识及临床诊治水平。方法回顾性分析2014年4月—2020年6月于我院诊治且经术后病理确诊为GCP的病人31例,分析其临床症状、病理、内镜及影像学表现等临床资料。结果31例病人中男22例,女9例,平均年龄(58.00±11.08)岁;临床表现为腹痛11例,腹部不适7例,腹胀6例,无症状7例;发病部位为胃体14例(45.2%),胃窦7例(22.6%),胃底5例(16.1%),贲门3例(9.7%),胃角及幽门各1例(3.2%)。29例行CT检查,结果显示胃壁增厚19例,低密度影1例,未见明显异常9例。超声内镜检查示:黏膜下隆起均匀低回声3例,不均匀低回声、均匀无回声、混杂无回声各1例。21例行内镜黏膜下剥离术(ESD)治疗,8例行手术治疗,2例行内镜下黏膜切除术治疗。术后病理检查显示:肿瘤性病变19例(61.3%),其中腺癌7例,低级别上皮内瘤变5例,管状腺瘤、印戒细胞癌各2例,高级别上皮内瘤变、鳞状细胞癌、脂肪瘤各1例;非肿瘤性病变12例(48.7%),其中慢性萎缩性胃炎7例,慢性非萎缩性胃炎2例,胃息肉3例。25例(80.6%)GCP病灶Ki-67指数≥10%,其中肿瘤性病变18例,非肿瘤性病变7例。结论GCP病人以男性为主,临床症状及内镜表现均不典型,CT结合超声内镜检查有助于疾病的鉴别诊断,最终确诊需病理学结果。临床需警惕其是否伴发或转化为恶性肿瘤。
Objective To investigate the clinical features of gastritis cystica profunda(GCP),and to improve the understanding of GCP and the level of clinical diagnosis and treatment.Methods A retrospective analysis was performed for the clinical data of 31 patients who were diagnosed and treated in our hospital from April 2014 to June 2020 and were diagnosed with GCP based on postoperative pathology,including clinical symptoms,pathology,and endoscopic and imaging findings.Results Among the 31 patients,there were 22 male patients and 9 female patients,with a mean age of(58.00±11.08)years.As for clinical manifestations,11 patients had abdominal pain,7 patients had abdominal discomfort,6 patients had abdominal distension,and 7 patients had no symptoms;as for the lesion site,14(45.2%)patients had the lesion in gastric body,7(22.6%)had the lesion in gastric antrum,5(16.1%)had the lesion in gastric fundus,3(9.7%)had the lesion in cardia,1(3.2%)had the lesion in gastric angle,and 1(3.2%)had the lesion in pylorus.CT examination was performed for 29 patients,and the results showed gastric wall thickening in 19 patients,low-density shadow in 1 patient,and no obvious abnormalities in 9 patients.Endoscopic ultrasound showed that 3 patients had homogeneous hypoechoic area in submucosal masses and 1 patient each had heterogeneous hypoechoic area,homogeneous anechoic area,and heterogeneous anechoic area.Of all patients,21 underwent endoscopic submucosal dissection,8 underwent surgical treatment,and 2 underwent endoscopic mucosal resection.Postoperative pathology showed neoplastic lesions in 19 patients(61.3%)(7 with adenocarcinoma,5 with low-grade intraepithelial neoplasia,2 with tubular adenoma,2 with signet-ring cell carcinoma,1 with high-grade intraepithelial neoplasia,1 with squamous cell carcinoma,and 1 with lipoma)and non-neoplastic lesions in 12 patients(48.7%)(7 with chronic atrophic gastritis,2 with chronic non-atrophic gastritis,and 3 with gastric polyps).Of all patients,25(80.6%)had a Ki-67 index of≥10%for GCP lesion,among whom 18 had neoplastic lesions and 7 had non-neoplastic lesions.Conclusion GCP is often observed in male individuals,with atypical clinical symptoms and endoscopic findings.CT combined with endoscopic ultrasound may help with the differential diagnosis of the disease,and final diagnosis requires pathological results.The presence or absence of malignant tumor or transformation to malignant tumor should be taken seriously in clinical practice.
作者
李航
纪清连
杨雪莲
王小玮
李晓宇
徐永红
LI Hang;JI Qinglian;YANG Xuelian;WANG Xiaowei;LI Xiaoyu;XU Yonghong(Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)
出处
《青岛大学学报（医学版）》
2021年第6期837-840,共4页
Journal of Qingdao University(Medical Sciences)
基金
国家自然科学基金青年科学基金项目(81802-777)。
作者简介
第一作者:李航(1996-),男,硕士研究生;通信作者:徐永红(1968-),女,博士,主任医师,硕士生导师。E-mail:yonghong6868@sina.com。
