Clinical Study Of Pathology And Follow-up After Gastric Mucosal Intraepithelial Neoplasia

Objectives:To analyze the postoperative diagnosis and comparative study of patients with gastric mucosal intraepithelial neoplasia and its influencing factors.To analyze the outcome of gastric mucosal intraepithelial neoplasia and its influencing factorsMethods:Collected 88 patients with gastric mucosal low-grade intraepithelial neoplasia and gastric mucosal high-grade intraepithelial neoplasia underwent gastroscopy and pathological biopsy from August 2018 to January 2021 at the Digestive Endoscopy Center of Qingdao Municipal Hospital The case data of 59 patients,a total of 147 patients.To retrospectively analyze the clinical and pathological characteristics of patients with gastric mucosal low-grade intraepithelial neoplasia and gastric mucosal high-grade intraepithelial neoplasia,analyze the pathological comparison and influencing factors after gastric mucosal intraepithelial neoplasia,and analyze low-grade intraepithelial neoplasia The outcome and its influencing factors.Result:1.Gender and age distribution: LGIN patients have a wide age distribution,ranging from 30 to 79 years old.Among them,the 60-69 age group has the most patients,accounting for 40.9%.The male to female ratio is 1.38:1;the age of HGIN patients ranges from 41 to 79 years old.Among them,the 60-69 age group has the most patients,accounting for 47.5%,and the male to female ratio is 2.93:1.2.Endoscopic lesions: LGIN lesions include gastric antrum,gastric body,gastric horn,cardia/base of stomach.Among them,the lesions were mainly concentrated in the gastric antrum,accounting for 71.5%,and the cardia/basal of the stomach accounted for the least,2.2%;HGIN was mainly concentrated in the gastric antrum,accounting for54.2%,followed by the gastric horns,accounting for 20.3%,and the gastric body The pylorus,15.2%,the cardia/basal stomach,5%,and the pylorus,5%.3.HP infection: The HP infection rate of LGIN was 18.2%,of which the infection rate of the gastric antrum was significantly higher than that of other parts,but it was not statistically significant;the HP infection rate of HGIN was 37.2%,and the infection of the gastric antrum and gastric corner The rate was significantly higher than that of other parts,and it was not statistically significant.4.After LGIN underwent ESD,70.6%(24/34)maintained LGIN diagnosis,23.5%(8/34)upgraded to HGIN,and 5.88% developed cancer.After HGIN underwent ESD,55.4%(31/56)maintained the diagnosis of HGIN,3.57%(2/56)of the lesions degenerated into LGIN,and 41.1% had cancer.The postoperative pathological comparison of LGIN and HGIN patients was not related to gender,age,lesion site and HP infection.No significant statistical difference was found between the groups(P>0.05).The lesions with hyperemia or ulcers on the surface of LGIN are more likely to undergo pathological escalation;the lesions with ulcers on the surface of HGIN(60.9%)are more likely to become cancerous.5.Among the 88 patients with LGIN,58 patients completed follow-up,the follow-up time was 1-24 months,and the average follow-up time was 6.16±5.68 months.The regression of the disease accounted for 50.0%(29/58),and the stable disease accounted for 27.6%(16/58).Progress accounted for 22.4%(13/58).The pathological outcome of LGIN has nothing to do with gender,age,lesion location and HP infection.Conclusion:1.Low-grade intraepithelial neoplasia of gastric mucosa with hyperemia or ulcers on the surface is more likely to undergo pathological escalation;lesions with ulcers on the surface of high-grade intraepithelial neoplasia of gastric mucosa are more likely to become cancerous;2.Patients with low-grade intraepithelial neoplasia of the gastric mucosa have a certain potential for canceration.Gastroscopy follow-up is helpful to find early gastric cancer.