Contrast Study On Tubercle Of Atrophic Gastritis And Erosive Gastritis Between Magnifying Endoscopy And Common Endoscopy

Objective To Contrast the diagnosing effect between magnifying endoscopy and common endoscopy on atrophic tubercles and erosive tubercles and describe the micro feature of them.Methods We used one magnifying endoscopy(Olympus GIF- Q240Z) and two common endoscopys(Olympus GIF- Q240 and Olympus GIF- XQ240) to observe the gastric mucosa of those patients. According to the micro feature,we discerned the tubercles whether the atrophic tubercle or the erosive tubercle. Endoscopic diagnosis was made at real time. Biopsies which were taken from the observed sites were conserved in flasks.Interclass test of significance was did byχ2 analysis.Results Gastric pits were classified into six types: type A, type B, type C, type D, type E and type F. Type E gastric pits belongs to atrophic tubercles. Type F was found on the top of the atrophic tubercles. Type C was found in erosive tubercle. The result discloses that there is disparity between the diagnosing under magnifying endoscopy and common endoscopy. To discriminate tubercle of atrophic gastritis magnifying endoscopy outstrips common endoscopy. On diagnosing erosive tubercles, magnifying endoscopy and common endoscopy are no differential. There is no significant difference between them on this aspect.Under magnifying endoscopy,we found that sinus ventriculi mucosa of atrophic gastritis patient was gray and rough. Gastric pits on sinus ventriculi were presented like branch and graticule. Gastric pits of the atrophic tubercle have four features. (1) Gastric pits are enlargement and extend. (2) Distance between gastric pits is more widen. (3) Surface of the atrophic tubercle is not smooth. There are some ravines on it. (4) Usually, we can see F type gastric pits on the tip of atrophic tubercles. On the top of the atrophic tubercle there is no inflammation present. When we observed the erosive tubercles,we acquire that they often appearance on sinus ventriculi ,string-of-beads and along gastric wall. In acute stage,the erosive tubercle is engorged obviously. Under magnifying endoscopy, gastric pits of erosive tubercles have four features. (1) Gastric pits are enlargement and extend. (2) Distance between gastric pits is more widen. (3) Except inflammation center, surface of the erosive tubercle is almost smooth. (4) On the top of the erosive tubercle there is inflammation center where gastric pits were disappeared. And they were substitute with necrotic tissue.We have contrasted micro morphous of atrophic tubercles and erosive tubercles. The identical aspects are as follow. Gastric pits are enlargement and extend,and C type gastric pits are universal. The different aspects are as follow. There are no inflammation center on the atrophic tubercles, and on the top of them, E type and F type gastric pits are universal. But on the top of the erosive tubercle there is inflammation center where gastric pits were disappeared. A few of erosive tubercles can be found of F type gastric pits on the top. Surface of the atrophic tubercle is not smooth,but,surface of the erosive tubercle was almost smooth.Under common endoscopy,we diagnosis atrophic gastritis by the color of stomach mucosa,the rough degree of stomach mucosa and capillary network of sinus ventriculi mucosa. Generally, the color of the atrophic tubercles is yellow or crimson. The quantity of atrophic tubercles is larger than erosive tubercles. Under common endoscopy,we found that the features of erosive tubercles are more often appearancing on sinus ventriculi,string-of-beads and along gastric wall. The most importance is the inflammation center on the top of the erosive tubercle.Conclusion1. Magnifying endoscopy could be used to observe the microstructure of gastric pits. And biopsy will be made more exactly under magnifying endoscopy. 2. According to the feature of microstructure, magnifying endoscopy could diagnose atrophic tubercles more exactly than common endoscopy. The features of atrophic tubercles are as follow. Some ravines on the top and E type and F type gastric pits are universal to be seen on them. In fact, common endoscopy could also magnify the microstructure of stomach mucosa, but the magnifying degree is not high enough. Using it, we could not observe the microstructure of gastric pits clearly. And we can only diagnose atrophic tubercles by macroscopy appearance. Comparing with magnifying endoscopy, its coincidence on diagnosing atrophic tubercles is not satisfactory.3. On diagnosing erosive tubercles, magnifying endoscopy and common endoscopy are no differential. The reason is that erosive tubercles have an evident feature (the inflammation center). Either magnifying endoscopy or common endoscopy could find it easily.4. Ravines on the top, and E and F type gastric pits are the marks of atrophic tubercles.