Pakati peruzivo rwakakurumbira nezvecherechedzo yekutanga yeGastric, pane zvimwe zviitiko zvisingawanzoitika izvo zvinoda kutarisirwa uye kudzidza. Imwe yadzo ndeye HP-isina kunaka gastric cancer. Pfungwa ye "Epithelial Epithelial Tumor" ikozvino yanyanya kufarirwa. Pachave nemafungiro akasiyana pane iyo nyaya nyaya. This content theory is mainly based on the content related to the magazine "Stomach and Intestine", and the name also uses "HP-negative gastric cancer".
Rudzi urwu rwekurima rune hunhu hwenzvimbo dzakaderera, kuomerwa mukuzivikanwa, kuoma ruzivo rwekuzivikanwa, uye iyo Mesda-G maitiro haishande. Kudzidza kuzivikanwa uku kunoda kutarisana nematambudziko.
1. Basic ruzivo rweHP-isina kunaka gastric cancer
Nhoroondo
Munguva yakapfuura, yaitenda kuti mushonga mumwechete mukusimudzira uye kusimudzira kwegomarara reGastric kwaive nekona yeGastric yaive yechiitiko, saka metini Muenzaniso wechirongwa wagara uchizivikanwa zvakanyanya, unogamuchirwa uye unotenda zvakasimba. Tumory inokudziridza pamwe chete pahwaro hweTrophy uye pasi pechiitiko cheHP, saka cancers zvakanyanya kukura mumatambudziko emukati ematare uye mashoma asiri-atrophic gastric mucosa.
Gare gare, vamwe vanachiremba vakawana kuti cancer gastric inogona kuitika kunyange mukushaikwa kwehutachiona hweHP. Kunyangwe huwandu hwenzvimbo hwakanyanya kuderera, zvinoita zvechokwadi. Rudzi urwu rwegomarara remagani rinonzi HP-isina kunaka gastric cancer.
Nekunzwisisa zvishoma nezvishoma kwerudzi urwu kwechirwere, zvakadzama zvakarongeka zvekutarisa uye mapfupa zvakatanga, uye mazita ari kuramba achichinja. Paive nechinyorwa muna 2012 inonzi "gakava reGastric mushure mekushandiswa", chinyorwa muna 2014 chinonzi "hp-chisina kunaka gomputa", uye chinyorwa muna 2020 chinonzi "Epithelial tumors isina kutapukirwa neHP". Iro shanduko inoratidza kunzwisiswa uye kwakazara kunzwisisa.
GLL Mhando uye Maitiro Ekukura
Kune marudzi maviri makuru emhando yemari glands uye pyloric glass mudumbu:
Fungidziro yemhando (oxyntic glands) inogoverwa mu fundus, muviri, makona, nezvimwewo. Ivo vanovhenekesa vasina kuroora tubular gland. Ivo vakaumbwa nemabhodhi emuchero, masero madiki, masero emhuri, uye masero echiganho, mumwe nemumwe anoita mabasa avo. Pakati pavo, mukuru masero akavanzika PGI uye muc6 Staining vaive nemaonero akanaka, uye masero emhuri yePabatil akavanzika hydrochloric acid uye intrinsic factor;
Iyo pyloric glass iri mune gastric antrum nzvimbo uye inoumbwa nemabhuru emabhuru uye masero encocrine. Masero emercus ari muc6 yakanaka, uye eCocrine masero anosanganisira g, d masero uye enterrochromaffin masero. G maseru secrete gastrite, d masero secrete Somatostatin, uye enterochromasa cell secrete 5-ht.
Zvakajairika gastric mucosal masero uye tumor masero anovhara mhando dzakasiyana dzemhando dzakasiyana dzemapuroteni, dzakakamurwa "," Kutaura kweGastric uye mudumbu mucins inonzi phenotype uye kwete iyo chaiyo inatomical nzvimbo yemudumbu uye matumbo.
Kune mana sero phenotypes yegastric tumors: yakazara gastric, gastric-yakakura yakasanganiswa, mudumbu-mukuru akasanganiswa, uye mudikasi. Tumors dzinoitika pahwaro hwetimistal metanaplasia dzakawanda gastrointestinal yakasanganiswa phenotype tumors. Vakasiyanisa Cancers vanonyanya kuratidza mumuviri mhando (muc2 +), uye kusiyana cancers vanonyanya kuratidza gastric mhando (muc5ac +, muc6 +).
Kufunga HP isina kunaka kunoda imwe musanganiswa wekusanganiswa kwenzira dzakawanda dzekuona dzekutsunga kwakazara. HP-isina kunaka gastric cancer uye post-sterization gastric cancer ndiyo pfungwa mbiri dzakasiyana. Kuti uwane ruzivo paX-ray kuratidzwa kweHP-isina kunaka gastric cancer, ndapota tarisa kune yakakodzera chikamu che "dumbu uye mumatumbu" magazini "magazini.
2. Endoscopic kuratidzwa kweHP-isina kunaka gastric cancer
Endoscopic diagnosis ndiyo inotarisa yeHP-isina kunaka gastric cancer. Zvinonyanya kusanganisira mwero gland gadziriso gastric cancer, fund Gland mucosal type garme, sigge cell
1) Fundment Gland Type Gastric Cancer
-White yakasimudzwa maronda
Fundment Gland Type Gastric Cancer
Case 1: White, Yakarerwa Lessions
Tsanangudzo:Gastric Stands Fornix - Yakakura Curvature yeiyo Curtature yeCardia, 10 mm, chena, O-Lia Type (smt-like), pasina trophy kana mudumbu metanaplasia kumashure. Arbor-semidziyo yeropa inogona kuoneka pamusoro (nbi uye kuwedzera zvishoma)
Kuongororwa (zvakasanganiswa nePathology):U, O-1LA, 9MM, Fund CLDY TIMBA Gastric Cancer, PT1B / SMA2 (600μM), Ulo, LY0, VO, HMO
-White Flat Lesions
Fundment Gland Type Gastric Cancer
Case 2: Ichena, Flat / Flater / Flased Lesions
Tsanangudzo:Iyo anterior rusvingo rwe gastric yemhando yekumanikidza-madini (NBI uye AMPLIFIATION YAKAITWA)
Kuongororwa (zvakasanganiswa nePathology):U, 0-ILC, 14mm, fund Gland Type Gastric Cancer, PT1B / SMA2 (700μM), Ulo, LY0, VO, HMO
-Kumisikidza yakasimudzwa maronda
Fundment Gland Type Gastric Cancer
Case 3: tsvuku uye yakasimudzwa maronda
Tsanangudzo:Iyo Anterior rusvingo rweGreat Curvature yeCartature Curvature yeCarthature yeMamiti gumi nemaviri, Type 0-1, isina Atropy Fraster, uye miganhu yeropa pamusoro (NBI nemidziyo yeNi uye nekuwedzera zvishoma)
Kuongororwa (zvakasanganiswa nePathology):U, 0-1, 12mm, fund Gland Type Gastric Cancer, PT1B / SM1 (200μM), Ulo, Lyo, VO, HMO
-Ared, flat, yakaora mwoyo lesions
Fundment Gland Type Gastric Cancer
Case 4: Tsvuku, flat / kushungurudzika maronda
Tsanangudzo:Posterior rusununguko rukuru rwechikamu chepamusoro chechikamu chegastric, 18mm, chiedza chitsvuku, hapana mutsara wetsiva, hapana midzi yeropa,
Kuongororwa (zvakasanganiswa nePathology):U, o-1lc, 19mm, fund Gland Type gastric cancer, pt1b / sm1 (400μm), Ulo, Lyo, VO, VMO
kurukura
Vanhurume nechirwere ichi vakura kupfuura vakadzi, vane zera repakati kuve makore makumi matanhatu nematanhatu. Nekuda kwehunhu hwekutanga uye heterochrony, varwere vakaonekwa neMifund Gland Gastric Gariki Gastric Cancer inofanira kuongororwa kamwe chete pagore. Iyo yakajairika saiti ndiyo fundo gland nzvimbo pakati nepakati uye chikamu chepamusoro chedumbu (iyo fundus uye yepakati uye yepamusoro chikamu chemuviri wegastric). White SMT-SEZVIMWE YAKASHUMIRA LESIONS yakajairika muchiedza chena. Kurapa kukuru kuri kuongorora EMR / ESD.
Hapana lymphatic metastasis kana vascular yekupinda yakaonekwa kusvika pari zvino. Mushure mekurapwa, zvinodikanwa kuti uone kana kuita kumwe kuvhiyiwa uye kuongorora hukama pakati pekuwachira mamiriro uye hp. Haasi ese fundic gland-mhando gastric cancers ndeye hp isina kunaka.
1) Mariro Gland Mucosal Gastric Cancer
Fundment Gland Mucosal Gastric Cancer
Case 1
Tsanangudzo:Iyo lesion yakamutswa zvishoma, uye rac isiri-atrophic gastric mucosa inogona kuonekwa yakakomberedza. Vanokurumidza kuchinja microntation uye microvessels inogona kuoneka mune yakasimudzwa chikamu cheangu-nbi, uye dl inogona kuonekwa.
Kuongororwa (zvakasanganiswa nePathology):Fund Cold Gland Mucosal Gastric Gastric Cancer, U Zone, 0 -LA, 47 * 32 * 32 (4003), Ulo, LY0, VO, HMO
Fundment Gland Mucosal Gastric Cancer
Case 2
Tsananguro.
Kuongororwa (zvakasanganiswa nePathology): Mariro Gland Mucosal Gastric Cancer, 0-Lla, Pt1a / M, Ulo, Lyov0, HM0, vmo
kurukura
Iro zita re "Gastric Gland mucosal Acenecarcinma" rakanyanya kuoma kududza, uye chiyero chakaderera kwazvo. Zvinoda kuedza kwakawanda kuziva uye kuzvinzwisisa. Fundment Gland mucosal adenoarcinoma ine maitiro ezvakanaka zvakakwirira.
Pane mana makuru maitiro eiyo chena mwenje weChiedza: ① Homochromatic-Fading Lesions; ② Subepithelial Tumor Smt; ③ yakagadzirwa nemidziyo yeropa yeropa; ④ microparticles yemudunhu. Me performance: DL (+) imvp (+) Imp (+) mce gentns ip uye inowedzera. Uchishandisa mesda-g yakakurudzirwa maitiro, 90% yeiyo Fundment Gland Mucosal Gastric Concers inosangana nemaitiro ekuongorora.
3) Gastric Adenoma (Pyloric Gland Adenoma PGA)
Gastric Adenoma
Case 1
Tsanangudzo:Chena chena yakasimudza lesion yakaonekwa pane iyo yepashure madziro egastric fornix neasina kujeka miganhu. Indigo carmine staining yakaratidza miganhu yakajeka, uye iyo lst-g-sida yemumugwagwa mukuru wakaonekwa (wakurisa zvishoma).
Kuongororwa (zvakasanganiswa nePathology):Low Atypia Carcinoma, O-1la, 47 * 32mm, yakasarudzika tubular adenoarcinma, pt1a / m, ulo, ly0, vo, hmo, vmo, vmo, vmo
Gastric Adenoma
Case 2
Tsananguro. Active gastritis inogona kuoneka kumashure. IndiaGo Carmine inogona kuonekwa seganhure. (NBI nekukura zvishoma)
Pathology: Muc5ac kutaura kwakaonekwa mune yepamusoro epithelium, uye muc6 kutaura kwakaonekwa mune yepamusoro yepamusoro epithelium. Kuongororwa kwekupedzisira kwaive pga.
kurukura
Gastric Adenomas ane hunyanzvi mulininos dols ichipinza stoma uye akafukidzwa neFoveolar epithelium. Nekuda kwekuwedzera kweiyo glandular trotsions, ayo ari hemispherical kana nodular, gastric adenomas yakaonekwa neEndoscopic White mwenje ndege dzese dzeNodoscopic. Izvo zvinodikanwa kuti utarisire kune iyo 4 maComsificifies yeJIU Ming pasi pekuongororwa kweEndoscopic. Me-nbi inogona kucherechedza hunhu hwepapillary / kusiyana kwekutaridzika kwePGA. PGA haina zvachose HP isina kunaka uye isiri-atrophic, uye ine imwe njodzi yekudzima. Kuongororwa kwekutanga uye kurapwa kwekutanga zvinotsigirwa, uye mushure mekuwanikwa, inoshanda en bloc kutongwa uye zvakare yakadzama kudzidza inokurudzirwa.
4) (raspberry-senge) Feveolar epithelial gastric cancer
raspberry foveolar epithelial gastric cancer
Case 2
Tsanangudzo:(akasiyiwa)
Kuongororwa (zvakasanganiswa nePathology): Foveolar Epithelial Gastric Cancer
raspberry foveolar epithelial gastric cancer
Case 3
Tsanangudzo:(akasiyiwa)
Kuongororwa (zvakasanganiswa nePathology):Feveolar epithelial gastric cancer
kurukura
Raspberry, inonzi "tuobai'er" mutaundi rekumusha kwedu, chibereko chesango munzira patakanga tiri vana. Gelandular EpitHelium uye gland dzakabatana, asi hazvisi izvo zvakafanana. Izvo zvinodikanwa kuti unzwisise kukura uye kusimudzira hunhu hwemasero epitheliari. Raspberry epithelial gastric cancer yakafanana neGastric Polyps uye inogona nyore kuva kukanganisa polyps. Iyo hallmark chimiro che fuveolar epithelium ndiyo inotonga kutaura kwe muc5ac. Saka foveolar epithelial carcinoma ndiyo general izwi rerudzi urwu. Inogona kuvapo muHP isina kunaka, yakanaka, kana mushure mekusvibiswa. Endoscopic chitarisiko: Kutenderera kwakajeka tsvuku tsvuku stawberry-kunge bulge, kazhinji ine miganhu yakajeka.
5) Signet Ring Cell Carcinoma
Signet Ring Cell Carcinoma: White Light chitarisiko
Signet Ring Cell Carcinoma: White Light chitarisiko
Signet Ring Cell Carcinoma
Case 1
Tsanangudzo:Flat Lesion paMusvingo weGastric Vestibule, 10 mm, yakapera, hapana mugero wekutanga, NDIMI.
Kuongororwa (zvakasanganiswa nePathology):Esd fungidziro inoshandiswa kuongororwa siginecha yeCarcinoma.
Kuratidzwa kwePological
Signet Ring Cell Carcinoma ndiyo yakanyanya kuwanda mhando. Maererano neLaureen Classificifation, Gastric Signet Mhete Cell Carcinoma inogadziriswa seyakagadziriswa mhando yeCarcinoma uye iri mhando yeisina kukodzera carcinoma. Izvo zvinowanzoitika mumuviri wedumbu, uye unowanzoitika mufurati uye hwakaoma uye hwakaiswa maronda. Yakasimudzwa maronda haina kujairika uye inogona zvakare kuratidza seyakarukwa kana maronda. Zvakaoma kuona panguva yekubvunzana kwekupedzisira mumatanho ekutanga. Kurapa kunogona kuve kwakadzikwa kwakadai seEndoscopic esd, nekuteedzera kwakasimba kwekutevera uye kuongororwa kwekutevera kwekuti kuita kumwe kuvhiyiwa. Kubata kusiri-kwechiitiko kunofanirwa kuda kumwe kuvhiyiwa, uye nzira yekuvhiya inosarudzwa neanovhiya.
Iyo yepamusoro yepamusoro fungidziro uye mifananidzo inouya kubva ku "dumbu uye mudumbu"
Mukuwedzera, kutarisirwa kunofanirawo kubhadharwa kune Esophagogastric Junction cancer, Cancer cancer, uye yakanyatsobatana Adenoarcincinma inowanikwa muHP-isina kunaka kumashure.
3. Pfupiso
Nhasi ini ndakadzidza ruzivo rwakakodzera uye zvinopindirwa zveVETOSCOPIC yeHP-isina kunaka gastric cancer. Izvo zvinonyanya kusanganisira: Mariro Gland Type Gastric Cancer, Fundment Grantal Type Gastric Type, (Raspberry-like) Foveolar Epithelial Bundu uye Signet Ring Cellcinoma.
Kiriniki chiitiko cheHP-isina kunaka gastric cancer yakaderera, zvakaoma kutonga, uye zviri nyore kupotsa kuongororwa. Izvo zvakatonyanya kuoma ndiko kuratidzwa kweEndoscopic kwezvirwere zvakaoma uye zvisingawanzoitika. Izvo zvinofanirwa zvakare kunzwisiswa kubva kune endoscopic maonero, kunyanya ruzivo rwechokwadi shure kwayo.
Kana iwe ukatarisa phepeni dzeGastric, gadziriso, uye nzvimbo dzvuku nenzvimbo, iwe unofanirwa kufunga nezve mukana weHP-isina kunaka gastric cancer. Kutongwa kweHP kwakashata kunofanira kutevedzera zviyero, uye kutarisirwa kunofanirwa kubhadharwa kune enhema dzenhema dzinokonzerwa nekuvimbika pamhepo yekufema miedzo yebvunzo. Vane ruzivo endoscopist vanovimba nemaziso avo zvimwe. Kutarisana nedzidziso yakadzama shure kweiyo HP-isina kunaka gastric cancer, tinofanira kuramba tichidzidza, kunzwisisa uye kudzidzira kuzvibata.
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Kutumira Nguva: Jul-12-202024