CAJ | 학술논문

目的：分析深在性囊性胃炎（GCP）与早期胃癌（EGC）之间的关系，探讨 GCP 的内镜诊治方案。方法收集病理诊断 GCP 病例17例，分析患者临床资料，包括临床症状、白光内镜、窄带放大内镜（ME-NBI）、超声内镜表现及组织病理学等方面特点。结果17例 GCP 患者均无特异性的临床症状，术前均无胃外科手术史。病变部位位于贲门8例、胃体4例、胃窦4例、胃角1例。病变内镜下大体形态Ⅰ型3例、Ⅰ＋Ⅱc 型3例、Ⅱa ＋Ⅱc 型9例、Ⅱc 型1例、Ⅱb ＋Ⅱc 型1例，病灶平均直径约1.8 cm。16例 GCP 术前行超声内镜检查，11例发现囊性回声改变，诊断率达68.8％（11／16）。17例 GCP 均行内镜黏膜下剥离术（ESD），14例（82.4％）合并 EGC。术后病理为低级别上皮内瘤变3例、高级别上皮内瘤变7例、黏膜内癌（均侵及黏膜肌层）4例、黏膜下浸润癌3例。结论超声内镜对 GCP 的诊断具有指导意义，GCP 与 EGC 的关系并非简单的合并现象；合并 EGC 病变应及时处理。
목적：분석심재성낭성위염（GCP）여조기위암（EGC）지간적관계，탐토 GCP 적내경진치방안。방법수집병리진단 GCP 병례17례，분석환자림상자료，포괄림상증상、백광내경、착대방대내경（ME-NBI）、초성내경표현급조직병이학등방면특점。결과17례 GCP 환자균무특이성적림상증상，술전균무위외과수술사。병변부위위우분문8례、위체4례、위두4례、위각1례。병변내경하대체형태Ⅰ형3례、Ⅰ＋Ⅱc 형3례、Ⅱa ＋Ⅱc 형9례、Ⅱc 형1례、Ⅱb ＋Ⅱc 형1례，병조평균직경약1.8 cm。16례 GCP 술전행초성내경검사，11례발현낭성회성개변，진단솔체68.8％（11／16）。17례 GCP 균행내경점막하박리술（ESD），14례（82.4％）합병 EGC。술후병리위저급별상피내류변3례、고급별상피내류변7례、점막내암（균침급점막기층）4례、점막하침윤암3례。결론초성내경대 GCP 적진단구유지도의의，GCP 여 EGC 적관계병비간단적합병현상；합병 EGC 병변응급시처리。
Objective To study the relationship between gastritis cystica profunda (GCP)and early gastric cancer (EGC),and to explore the diagnosis and treatment of GCP.Methods Clinical data of 17 patients,who were pathologically diagnosed as having GCP,including clinical symptoms,white light endo-scopic findings,magnifying endoscopic features,EUS outcomes and histopathological characteristics were an-alyzed.Results All 17 patients of GCP had no specific clinical symptoms or history of gastric surgery prior to the operation.Eight lesions were located at cardiac,4 at gastric body,4 at gastric antrum and 1 at gastric angle.As to the morphology,3 cases were type Ⅰ,3 type Ⅰ +Ⅱc,9 type Ⅱa +Ⅱc,1 type Ⅱc and 1 type Ⅱb +Ⅱc.The mean lesion size was 1.8 cm.Of 16 patients with preoperative EUS examination,11 patients were found to have cystic changes,with the diagnostic rate being 68.8%(11 /16).All 17 patients underwent ESD,14 (82.4%,14 /17)of which were found to have EGC.Postoperative pathology confirmed low grade intraepithelial neoplasia in 3 cases,high grade intraepithelial neoplasia in 7,intramucosal carcino-ma in 4,submucosal carcinoma in 3 patients.Conclusion EUS plays an important role in the diagnosis and treatment of GCP.And GCP is highly correlated with EGC,which should be managed in time.