| Fundic gland polyps is refers to the bottom of the stomach mucous membrane of the gastric body formed by single or multiple wide base polypoid uplift,is now a common histological types of gastric polyps.WHO launched the digestive system tumor classification in the latest version of the gastric polyp broadly divided into two categories:adenomatous polyp and the adenomatous polyp.Gastric adenomatous polyp lesions including a polypoid appearance of cancer,neuroendocrine tumor,adenomatous polyp,gastric adenoma(pyloric gland adenoma and small concave type adenoma) as well as fundic gland polyps(fundic gland polyps, FGPs).Other polypus lesions such as hyperplastic polyp,hamartoma polyps and other polypoid growth way lesions were classified as non cancerous lesions.Fundic gland polyps, adenomatous polyp is classified as,but generally is considered to be benign lesions, clinical often happens.Fundic gland polyps pathogenesis is not clear at present, the lack of clinical diagnostic and guide.Always think that familial adenomatous polyposis(familial adenomatous polyposis, FAP) often merge FGPs,their risk of cancer is very high.But in recent years,reports of FAP patients FGPs also occur.Domestic cases of fundic gland polyps in observation is not much,about the clinical and pathological characteristics of fundic gland polyps targeted treatment, etc,are subject to further study.FAP patients more merger adenomatous polyposis coli(APC) and its downstream target targeted gene beta connexins genetic mutation.Beta connecting element is the key of the Wnt signaling pathways in cancer molecular,activate the downstream target genes of Cyclin D1 transcription,cell proliferation and differentiation out of control and lead to cancer.Domestic about the FAP fundic gland polyps in patients with large observation cases is not much,about the clinical and pathological characteristics of fundic gland polyps targeted therapy,whether abnormal beta connexins Cyclin D1 and protein expression,etc,are subject to further study.Objective:This study aims to through the analysis summary the clinical charact- eristics of 200 cases fundic gland polyps,histomorphology and immune phenotypic characteristics,to explore the clinical pathological characteristics of fundic gland polyps,diagnosis and treatment of fundic gland polyps specification to provide pathological basis.Methods:1 Collected in October 2009 to July 2014, the second hospital, hebei medical university digestive endoscopy center gastroscopy biopsy after, confirmed by pathology of fundic gland polyps,200 cases of patients with archive wax block.Collect patients’ clinical data and with the exception of familial adenomatous polyposis, juvenile polyposis, Peutz- Jeghers syndrome, etc.And weed out the same patient at times gastroscope biopsy cases.Among them, male 34 cases, 166 cases of women;Age is 21 years old to 79 years old.2 Immunohistochemical staining were used to detect Of 200 cases of fundic gland polyps, randomly select 50 cases of immunohistochemical staining.A fight of rat respectively fight people beta link element monoclonal antibody and rabbit anti human cycle D1 monoclonal antibody, the former cloned,working liquid, organization during the processing of antigen hot fix, positive part in the cell membrane or cell plasma.The latter EP12 cloning, working liquid,antigen of organization in the process does not need to repair, positive part in the nucleus.GBI companies in the United States 2- step plus immunohistochemical spectrum detection kit(PV-9000), DAB staining, wood grain after dying. Each dyeing is to set up the positive control and negative control,with PBS liquid instead of one as a negative control.With the cell membrane, cytoplasm or cell nucleus appeared tan particles as positive.3 The statistical analysis experimental data application SPSS19.0 statist- ical software, using X2 test,P values<0.05,considered statistically significant.Results: 1 fundic gland polyps clinical characteristics 1.1 age and genderIn this study,200 patients with fundic gland polyps, aged 21 to 79, the average age of 54.Women accounted for the vast majority, accounting for 83%(166/200).Men accounted for about 17%(34/200).Compared with the incidence of male patients with incidence of female patients, female patients with obvious majority,there are significant differences(P<0.01).34 men generally older patients,with an average age of 68.Women with an average age of 51.1 years.Women compared with men,different onset ages,there is significant difference(P<0.01). 1.2 symptoms more than 200 fundic gland polyps patients with upper gastrointestinal discomfort,and no specific symptoms.Later in the upper gastrointestinal tract gastroscopy were found in gastric polyp,or after the biopsy pathology diagnosis confirmed as fundic gland polyps. 2 fundic gland polyps under endoscopic featuresMore than 200 cases of fundic gland polyps under endoscope is located at the bottom of the stomach or gastric mucosa, single or multiple light pink base polypoid uplift.Single sex fundic gland polyps in 89 cases, accounting for 44.5% of the fundic gland polyps(89/200).Which is located in the bottom of the stomach 52 cases(58.4%, 52/89),located in gastric body,34 cases(38.2%,34/89),the remaining 3 cases located in gastric antrum(3%).Multiple fundic gland polyps in 111 cases, accounting for 55.5% of the fundic gland polyps(111/200), located in the bottom of the stomach or gastric body.More than 200 cases of fundic gland polyps diameter less than 5 mm(89%,178/200).In this study with 19 patients with upper gastrointestinal examination found that combined esophagitis, and hiatal hernia, gastric duodenal ulcer or other benign gastrointestinal diseases such as gastric stromal tumors. 3 The most morphological characteristics of fundic gland polyps tissue was covering epithelium as a simple epithelium, gland nest short and straight surface, lamina propria gland is mainly composed of wall cells and primary cells, often accompanied by mucus cells of small cysts.Of 200 cases of fundic gland polyps, 8 cases with epithelial hyperplasia.Im not seen performance. 4 fundic gland polyps tissue beta link element and the periodic element D1 expression Of 50 cases of fundic gland polyps, as polyps in cell membrane beta-strong expression of connexins.The expression rate of 100%.No beta connexins expression of the nucleus.Beta-links between different gender, the expression of no difference(P>0.05).Of 50 cases of fundic gland polyps, no polyp of cells within the cytoplasm or nucleus cycle D1 expression, expression rate was 0%.Cycle between different gender, the expression of D1 no difference(P>0.05).Conclusions:1 200 cases of fundic gland polyps patients were more women.2 Fundic gland polyps tissue had not the mutation ofβ-catenin,and abnomal cycle D1 expression.3 Fundic gland polyps low malignant potential. |
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