深在性囊性胃炎40例临床诊治分析

Diagnosis and treatment of 40 cases of gastritis cystica profunda

摘要:

目的探讨深在性囊性胃炎（GCP）的临床、内镜下及病理特点，以提高临床对该病的认识。方法2013年5月至2018年5月，在上海交通大学医学院附属仁济医院行内镜或手术诊治，经病理证实为GCP患者40例纳入回顾性研究，对其人群构成、临床表现、内镜表现及病理结果等临床资料进行总结分析。结果40例患者中，以男性为主（75.0%，30/40），平均发病年龄为61.2岁，好发部位为贲门（32.5%，13/40）及胃窦（30.0%,12/40），患者临床症状多不典型，常规胃镜诊断GCP困难，内镜下多表现为0-Ⅱ型（50.0%，20/40）。病理证实GCP合并有肿瘤性病变者占55%（22/40），非条件logistic回归分析发现，男性（P=0.013，OR=31.093，95%CI：2.079～464.976）及幽门螺杆菌感染（P=0.041，OR=10.225，95%CI：1.096～95.411）为GCP合并肿瘤性病变的危险因素。结论GCP好发于中老年男性，白光内镜下表现不一，并非单纯良性病变，可合并有肿瘤性病变，多为分化型黏膜内癌。

Abstract:

ObjectiveTo investigate the clinical, endoscopic and pathological features of gastritis cystica profunda (GCP). MethodsA total of 40 patients with GCP confirmed by pathology who received endoscopic or surgical treatment at Renji Hospital, School of Medicine, Shanghai Jiaotong University from May 2013 to May 2018, were included in the retrospective analysis. The clinical data such as population composition, clinical manifestations, endoscopic findings and pathological results were summarized and analyzed. ResultsAmong the 40 patients were predominantly males (75.0%, 30/40), and the mean age of onset was 61.2 years. The most common sites were cardia (32.5%, 13/40) and gastric antrum (30.0%, 12/40). The clinical symptoms of the patients were atypical and it was difficult to diagnose GCP with routine endoscopy examination. The endoscopic findings were mostly type 0-Ⅱ (50.0%, 20/40). GCP with neoplastic lesions accounted for 55% (22/40). Unconditional logistic regression analysis showed that male (P=0.013, OR=31.093, 95% CI: 2.079-464.976) and Helicobacter pylori infection (P=0.041, OR=10.225, 95% CI: 1.096-95.411) were risk factors for GCP with neoplastic lesions. ConclusionGCP commonly occurs in middle-aged and elderly men，and varies in different manifestations under white light endoscopy. GCP is not a benign lesion, but can also coexist with neoplastic lesions, which are mostly differentiated intramucosal cancer.