胃镜下病理组织学方法对幽门螺旋杆菌感染诊断影响因素分析

Analysis of the Influential Factors between Gastroscopic Manifestations and Pathological Diagnosis of Hp Infection

摘要: 目的：探讨幽门螺旋杆菌(Hp)的胃镜下表现与病理组织学诊断的相关性。方法：选取280例慢性胃炎的患者行Hp病理组织免疫学诊断。观察窄带成像放大内镜(arrow-bandimaging magnification endoscopy, NBI-ME)下胃黏膜微细结构及病理类型与Hp感染的关系，分析胃镜与病理诊断结果符合程度及影响因素。结果：280例中有129例经病理组织学检查诊断为Hp相关性胃炎。NBI-ME下胃小凹与侧集合静脉微观结构Hp感染率最高的为C + D₂型，阳性率占86.84%，较其他结构差异有统计学意义(P < 0.05)；病理类型中Hp感染率最高的为肠上皮化生型，阳性率为53.45%，而较其他类型差异无统计学意义(P > 0.05)；NBI-ME胃镜诊断与病理诊断符合率为98.57%。病理组织显示胃镜下诊断4例为假阳性且胃小凹与侧集合静脉微观结构均为C + R型。结论：临床中应重视新型胃镜检查技术与病理检查相结合，加强胃镜下形态认识，规范典型部位活检，以提高两者诊断符合率。

Abstract: Objective: To explore the correlation of endoscopic and pathological diagnosis of Helicobacter pylori bacteria. Methods: 280 patients diagnosed as gastritis by gastroscopy were selected through the detection and collection of the pathological diagnosis. The pit shape in antrum and vein shape in greater curvature of the gastric body were observed and their relationship with Hp infection. The degree of coincidence between gastroscopy and pathological diagnosis and the influencing factors were analyzed. Results: In the 280 patients, 129 cases were diagnosed Hp infection by the pathological diagnosis. The Hp infection rates of C + D₂ type were 86.84% (P < 0.05) which showed had highest Hp infection and the Hp infection rates of Intestinal metaplasia were 53.45% (P > 0.05). The accordant rates of these two methods reached 98.57%. The pathology showed that 4 cases were false positive and the microstructures of gastric fovea and lateral collecting vein were all C + R type. Conclusion: It should be combined with the new type of gastroscopy and pathological examination in clinic, and should pay more attention to the typical site biopsy and strengthen morphological understanding of endoscopic morphology, and also standardize the endoscopic operation. It can ultimately improve the diagnostic coincidence rate of these two methods.