临床荟萃
臨床薈萃
림상회췌
CLINICAL FOCUS
2015年
1期
30-33
,共4页
马毓梅%孙鹏娟%王恒树%崔爱荣%张杰英
馬毓梅%孫鵬娟%王恆樹%崔愛榮%張傑英
마육매%손붕연%왕항수%최애영%장걸영
息肉%增殖细胞核抗原%角蛋白质类%诊断%免疫组织化学
息肉%增殖細胞覈抗原%角蛋白質類%診斷%免疫組織化學
식육%증식세포핵항원%각단백질류%진단%면역조직화학
polyps%proliferating cell nuclear antigen%keratins%diagnosis%immunohistochemistry
目的：观察单发胃息肉样病变的内镜和病理形态学特征，探讨不同类型胃息肉的增殖和分化特征。方法分析661例单发性胃息肉样病变临床病理特点，免疫组织化学 EliVisionTMplus 两步法检测63例各类型胃息肉增殖细胞核抗原（Ki67），细胞角蛋白7（CK7），细胞角蛋白20（CK20）的表达。结果内镜诊断661例单发胃息肉样病变多为炎症，只有34．9％（231／661）诊断为胃息肉；单发性胃息肉样病变主要发生于胃窦；其中增生性息肉157例，在息肉中所占比例最高，多发生在胃窦部和贲门；胃腺瘤仅7例，主要发生于胃窦；除炎性纤维性息肉外，胃息肉的腺上皮均有不同程度 Ki-67表达，胃腺瘤的 Ki-67标记指数明显高于其他胃息肉（P ＜0．05）；胃息肉腺上皮免疫表型以CK7＋／CK20＋为主。结论胃息肉临床病理诊断符合率较低；不同类型胃息肉增殖指数不同，但免疫表型相似。
目的：觀察單髮胃息肉樣病變的內鏡和病理形態學特徵，探討不同類型胃息肉的增殖和分化特徵。方法分析661例單髮性胃息肉樣病變臨床病理特點，免疫組織化學 EliVisionTMplus 兩步法檢測63例各類型胃息肉增殖細胞覈抗原（Ki67），細胞角蛋白7（CK7），細胞角蛋白20（CK20）的錶達。結果內鏡診斷661例單髮胃息肉樣病變多為炎癥，隻有34．9％（231／661）診斷為胃息肉；單髮性胃息肉樣病變主要髮生于胃竇；其中增生性息肉157例，在息肉中所佔比例最高，多髮生在胃竇部和賁門；胃腺瘤僅7例，主要髮生于胃竇；除炎性纖維性息肉外，胃息肉的腺上皮均有不同程度 Ki-67錶達，胃腺瘤的 Ki-67標記指數明顯高于其他胃息肉（P ＜0．05）；胃息肉腺上皮免疫錶型以CK7＋／CK20＋為主。結論胃息肉臨床病理診斷符閤率較低；不同類型胃息肉增殖指數不同，但免疫錶型相似。
목적：관찰단발위식육양병변적내경화병리형태학특정，탐토불동류형위식육적증식화분화특정。방법분석661례단발성위식육양병변림상병리특점，면역조직화학 EliVisionTMplus 량보법검측63례각류형위식육증식세포핵항원（Ki67），세포각단백7（CK7），세포각단백20（CK20）적표체。결과내경진단661례단발위식육양병변다위염증，지유34．9％（231／661）진단위위식육；단발성위식육양병변주요발생우위두；기중증생성식육157례，재식육중소점비례최고，다발생재위두부화분문；위선류부7례，주요발생우위두；제염성섬유성식육외，위식육적선상피균유불동정도 Ki-67표체，위선류적 Ki-67표기지수명현고우기타위식육（P ＜0．05）；위식육선상피면역표형이CK7＋／CK20＋위주。결론위식육림상병리진단부합솔교저；불동류형위식육증식지수불동，단면역표형상사。
ABSTRACT:Objective To observe the endoscopic and pathological features of single gastric polypoid lesion and to explore the proliferative and differentiated features of different types of gastric polyps.Methods The clinical pathological features of 661 cases with single gastric polypoid lesions were analyzed.Then,the expression of Ki-67,CK7 and CK20 of 63 cases with different types of gastric polyps were determined using EliVisionTM plus detection kit. Results Most of 661 cases diagnosed by endoscopy were inflammation by endoscpic examination.Gastric polyps only accounted for 34.9%(231/661).Single gastric polypoid lesion mainly happened in gastric antrum.Hyperplastic polyps always found in the antrum and cardia,accounted for the highest proportion in 231 cases of gastric polyps.There were only seven cases of gastric adenomas mainly found in the antrum.Except for the inflammatory fibroid polyps,Ki-67 expression was observed in all of the other types of gastric polyps at varying degrees.The mean labeling index of Ki-67 in adenoma was significantly higher than that of the other three gastric polyps and CK7 +/CK20+ was the main phenotype of gastric polyps except inflammatory fibroid polyps.Conclusion The diagnostic accordance rate of gastric polyps is relatively low in clinic.Different types of gastric polyp show different proliferation indexes but identical immune phenotypes.
