中华消化内镜杂志
中華消化內鏡雜誌
중화소화내경잡지
CHINESE JOURNAL OF DIGESTIVE ENDOSCOPY
2015年
1期
18-23
,共6页
崔荣丽%周丽雅%闫秀娥%金珠%张贺军%夏志伟%徐志洁%王晔%尚惠茹
崔榮麗%週麗雅%閆秀娥%金珠%張賀軍%夏誌偉%徐誌潔%王曄%尚惠茹
최영려%주려아%염수아%금주%장하군%하지위%서지길%왕엽%상혜여
Barrett食管%柱状上皮岛%肠上皮化生%胃食管反流病%pH阻抗监测
Barrett食管%柱狀上皮島%腸上皮化生%胃食管反流病%pH阻抗鑑測
Barrett식관%주상상피도%장상피화생%위식관반류병%pH조항감측
Barrett esophagus%Columnar-lined island%Intestinal metaplasia%Gastroesophageal reflux disease%pH-impedance monitoring
目的 探讨食管下段柱状上皮岛(CLI)的临床和病理特点以及与Barrett食管(BE)的关系.方法 回顾性收集2005年至2013年438例食管下段CLI患者的病例资料,总结内镜下形态学特点及活检病理组织学特点.对比分析27例CLI患者和23例非岛型(环周型或舌型)BE患者的阿尔辛蓝-过碘酸雪夫(AB/PAS)组织化学染色及MUC-2、MUC-6、CDX2、Ki-67免疫组化染色结果,31例CLI患者和28例非岛型BE患者的24h食管pH-阻抗监测结果.结果 CLI发现率以40 ～＜ 50岁最高(0.61％,104/17 164),其次为50 ～＜ 60岁(0.49％,107/21 794).438例食管下段CLI患者中,CLI距齿状线距离≤0.5 cm者323例(占73.7％),单发266例(占60.7％),最大直径＜0.5 cm者338例(占81.8％),幽门螺杆菌阳性者147例(占33.7％),单纯贲门型黏膜220例(占62.5％).27例CLI患者和23例非岛型BE患者的黏膜AB/PAS组织化学染色及MUC-2、MUC-6、CDX2、Ki-67免疫组化染色结果分析未见两者黏液特点、细胞增殖情况方面差异有统计学意义.31例CLI患者和28例非岛型BE患者的24 h食管pH-阻抗监测结果分析未发现两者在典型症状、食管远端反流情况方面差异有统计学意义.结论 食管下段CLI以40 ～＜ 50岁人群好发,CLI多位于齿状线上0.5 cm范围,多单发,最大直径多小于0.5 cm,固有腺体多为黏液腺,黏膜固有腺的黏液特点以及反流情况与非岛型BE相似,推测可能是BE的早期阶段.
目的 探討食管下段柱狀上皮島(CLI)的臨床和病理特點以及與Barrett食管(BE)的關繫.方法 迴顧性收集2005年至2013年438例食管下段CLI患者的病例資料,總結內鏡下形態學特點及活檢病理組織學特點.對比分析27例CLI患者和23例非島型(環週型或舌型)BE患者的阿爾辛藍-過碘痠雪伕(AB/PAS)組織化學染色及MUC-2、MUC-6、CDX2、Ki-67免疫組化染色結果,31例CLI患者和28例非島型BE患者的24h食管pH-阻抗鑑測結果.結果 CLI髮現率以40 ～＜ 50歲最高(0.61％,104/17 164),其次為50 ～＜ 60歲(0.49％,107/21 794).438例食管下段CLI患者中,CLI距齒狀線距離≤0.5 cm者323例(佔73.7％),單髮266例(佔60.7％),最大直徑＜0.5 cm者338例(佔81.8％),幽門螺桿菌暘性者147例(佔33.7％),單純賁門型黏膜220例(佔62.5％).27例CLI患者和23例非島型BE患者的黏膜AB/PAS組織化學染色及MUC-2、MUC-6、CDX2、Ki-67免疫組化染色結果分析未見兩者黏液特點、細胞增殖情況方麵差異有統計學意義.31例CLI患者和28例非島型BE患者的24 h食管pH-阻抗鑑測結果分析未髮現兩者在典型癥狀、食管遠耑反流情況方麵差異有統計學意義.結論 食管下段CLI以40 ～＜ 50歲人群好髮,CLI多位于齒狀線上0.5 cm範圍,多單髮,最大直徑多小于0.5 cm,固有腺體多為黏液腺,黏膜固有腺的黏液特點以及反流情況與非島型BE相似,推測可能是BE的早期階段.
목적 탐토식관하단주상상피도(CLI)적림상화병리특점이급여Barrett식관(BE)적관계.방법 회고성수집2005년지2013년438례식관하단CLI환자적병례자료,총결내경하형태학특점급활검병리조직학특점.대비분석27례CLI환자화23례비도형(배주형혹설형)BE환자적아이신람-과전산설부(AB/PAS)조직화학염색급MUC-2、MUC-6、CDX2、Ki-67면역조화염색결과,31례CLI환자화28례비도형BE환자적24h식관pH-조항감측결과.결과 CLI발현솔이40 ～＜ 50세최고(0.61％,104/17 164),기차위50 ～＜ 60세(0.49％,107/21 794).438례식관하단CLI환자중,CLI거치상선거리≤0.5 cm자323례(점73.7％),단발266례(점60.7％),최대직경＜0.5 cm자338례(점81.8％),유문라간균양성자147례(점33.7％),단순분문형점막220례(점62.5％).27례CLI환자화23례비도형BE환자적점막AB/PAS조직화학염색급MUC-2、MUC-6、CDX2、Ki-67면역조화염색결과분석미견량자점액특점、세포증식정황방면차이유통계학의의.31례CLI환자화28례비도형BE환자적24 h식관pH-조항감측결과분석미발현량자재전형증상、식관원단반류정황방면차이유통계학의의.결론 식관하단CLI이40 ～＜ 50세인군호발,CLI다위우치상선상0.5 cm범위,다단발,최대직경다소우0.5 cm,고유선체다위점액선,점막고유선적점액특점이급반류정황여비도형BE상사,추측가능시BE적조기계단.
Objective To analyze the endoscopic and histopathologic characteristics of columnarlined island(CLI) type of Barrett esophagus (BE) in the lower esophagus.Methods Data of 438 patients with CLI from 2005 to 2013 were reviewed,and endoscopic and histopathological characteristics were analyzed retrospectively.Immunohistochemical staining and AB/PAS staining were performed in 27 samples in CLI and 23 samples in non-island type BE.All the samples were observed by the pathologist and then analyzed.Twenty-four hour pH-impedance monitoring was conducted in 31 subjects with CLI and 28 subjects with non-island type BE.Results The highest incidence of CLI was found in patients aged from 40 to ＜ 50 (0.61％,104/17 164),followed by age 50 to ＜60(0.49％,107/21 794).There were 323 patients whose CLIs were within 0.5 cm above Z-line(73.7％),266 subjects with single CLI,maximum diameter shorter than 0.5 cm of CLI in 338(81.8％).One hundred and forty-seven got Hp infection(33.7％).There were 220(62.5％) gastric cardiac glandular type.There was no significant difference in AB/PAS staining,MUC-6,MUC-2,CDX2 and Ki-67 immunohistochemical staining between the CLIs (n =27)and non-island type BEs(without intestinal metaplasia).According to the pH impedance monitoring,no differences were found in the reflux parameters and the typical reflux symptoms between two groups.Conclusion CLIs in the lower esophagus are common among people aged 40-＜ 50,located within 0.5 cm above the Z-line,single,maximum diameter shorter than 0.5 cm,and with gastric cardiac glandular.There are no significant differences in the mucus expression,and the reflux parameters in CLIs and non-island type BEs.
