临床荟萃

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慢性胃炎的病理诊断

  

  1. 上海交通大学医学院附属仁济医院 消化内科,上海市消化疾病研究所,上海 200001
  • 出版日期:2019-05-20 发布日期:2019-06-28
  • 通讯作者: 崔云,Email:cuiyun20042004@126.com
  • 作者简介:崔云,博士,上海交通大学医学院附属仁济医院消化科。主要从事消化道肿瘤和非肿瘤性疾病的基础和临床研究。美国哈佛大学医学院附属波士顿健康系统VA医院,访问学者。主持国家自然科学基金青年项目1项。第一作者发表SCI论文2篇,共同第一作者1篇。
  • 基金资助:
    国家自然科学基金资助项目----p42.3基因在从胃炎到胃癌发展过程中的作用及其机制初探(81302084)

Pathologic diagnosis of chronic gastritis

  1. Department of Gastroenterology, Renji Hospital,  Shanghai Jiao Tong University School of
    Medicine,  Shanghai Institute of Digestive Disease, Shanghai 200001,  China
  • Online:2019-05-20 Published:2019-06-28
  • Contact: Corresponding author: Cui Yun, Email: cuiyun20042004@126.com

摘要: 慢性胃炎的病理诊断参照了新悉尼系统的直观模拟评分法和中国慢性胃炎共识意见(2017,上海),包括对慢性胃炎的炎症、活动性、萎缩、肠化和幽门螺杆菌进行半定量评价,并给予总结性分类。虽然幽门螺杆菌感染是最常见的原因,但是也不能忽视其他类型的慢性胃炎。病理评估时应尽可能提供病因学依据和线索。慢性胃炎的两个风险评估系统胃炎评价标准(OLGA)和胃黏膜肠化生评价标准(OLGIM)可以有效对胃癌的发生风险进行分层,建议纳入病理评估。完善的慢性胃炎病理诊断系统不仅可以指导临床治疗,也有利于慢性胃炎患者的管理、随访策略的制定以及早癌的筛查。

关键词: 胃炎, , 萎缩性;病理学, 临床;螺杆菌, , 幽门;诊断

Abstract: The pathologic diagnosis of chronic gastritis referred to the updated Sydney system and Chinese consensus on chronic gastritis (2017,  Shanghai) which included the semiquantitative evaluation of inflammation,  activity,  atrophy,  intestinal metaplasia,  H.pylori  infection and gave the related classification. Although H.pylori infection is the most common cause, other types of chronic gastritis should not be ignored.  Furthermore, the pathologic assessment should try to provide evidences or clues pointing to the etiology. OLGA and OLGIM were two effective systems to evaluate the risk to gastric cancer that were recommended as a part in the pathologic assessment. Complete pathologic diagnosis system could not only guide the clinical treatment,  but also facilitate the management of the chronic gastritis patients,  development of the followup strategy and early gastric cancer screening.

Key words: gastritis atrophic;pathology, clinical, Helicobacter pylori, diagnosis