Phakathi kolwazi oludumileyo malunga nomhlaza wokuqala kabukhali, kukho amanqaku olwazi olunqabileyo ofuna ingqwalaselo eyodwa kunye nokufunda. Omnye wabo ngumhlaza we-HP-ongenayo. Umxholo "we-epithelial turust" ngoku ithandwa kakhulu. Kuya kubakho izimvo ezahlukeneyo kumcimbi wegama. Le thiyori yomxholo ikakhulu isekwe kumxholo onxulumene nephephabhuku "isisu kunye nethumbu", kwaye igama elinguMhlaza we-GP-ongenayo ".
Olu hlobo lwezilonda luneempawu zezehlo eziphantsi, ubunzima bokuchonga ulwazi, ulwazi oluntsonkothileyo, kwaye i-GASDA-G ye-GESDA-G ayisebenzi. Ukufunda olu lwazi kufuna ukujongana nobunzima.
I-1. Ulwazi olusisiseko lwe-HP-Destric Daler
Imbali
Kwixa elidlulileyo, kwakukholelwa ukuba i-celpper enye kwindawo yokwenzeka kunye nophuhliso lomhlaza we-gestric yayingu-HP-Imodeli yoSukulolo yi-HP-I-ATAPOPYIAL-I-TIMPINAL-i-tumor ephezulu - umhlaza. Imodeli yeklasikhi ihlala ivunywa ngokubanzi, yamkelwe kwaye ikholelwa ngokuqinileyo. I-sumumpers iphuhlise kunye ngesiseko se-atrophy kwaye phantsi kwesenzo se-HP, ngoko ke imihlaza ikhule ikakhulu kumaphecana anexineneyo kunye ne-norophic mucosa ye-otrophic mucosa.
Emva kwexesha, abanye oogqirha bafumanisa ukuba umhlaza we-gastric unokwenzeka nangokungabikho kosulelo lwe-HP. Nangona inqanaba leNkululeko liphantsi kakhulu, linokwenzeka. Olu hlobo lomhlaza we-gestric lubizwa ngokuba nguMhlaza we-HP-of Gastric.
Ngokuqonda kancinci kolu hlobo lwezifo, ukuqaphela okucwangcisiweyo kunye nezishwankathelo sele zitshintshile rhoqo. Kwakukho inqaku ngo-2012 elibizwa ngokuba yi "Grastric Cancer Emva koSutho", inqaku ngo-2014 elibizwa ngokuba yi "HP-Godric Carecy", kunye nenqaku elibizwa ngokuba ngu "inqaku elibizwa ngokuba ngu-HP". Igama lokutshintsha libonisa ukuqonda okukhulu kunye nokuqonda.
Iindidi ze-Gland kunye neepateni zokukhula
Zimbini iintlobo eziphambili ze-flonds kunye ne-pyloric glumnd esiswini:
Amadlala eFunclic (amadlala e-oxyntic) asasazwa kwingxowa mali, umzimba, iikona, njl njl. Ngesisu. Banamadlala amaglasi enye. Baqulunqwe ngeeseli ze-mucous, iiseli eziphambili, iiseli zePrieetal kunye neeseli ze-endocrine, nganye nganye iqhuba imisebenzi yabo. Phakathi kwazo, iiseli eziphambili ze-PGI kunye ne-muc6 i-PGI ye-PGI kunye ne-MUC6 zilungile, kwaye iiseli ze-parigeal ze-hydrochloric acid kunye ne-intrinsic;
Amadlala e-Pyloric abekwe kwindawo ye-antrum entlukwe kwaye athatyathwe iiseli ze-mucus kunye neeseli ezi-endocrine. Iiseli ze-mucus ziyi-muc6 elungileyo, kunye neeseli ezi-endocrine zibandakanya g, d iiseli kunye neeseli ze-Enterochromaffini. G Iiseli ze-GECRINE GALETRIN, Iiseli zeD-DECRETE Somatostatin, kunye ne-Enterochromaffini ye-5-ht.
Iiseli eziqhelekileyo ze-gucosal kunye neeseli ze-tumor zikhule iintlobo ezahlukeneyo zeeproteni ze-mucus, ezahlulahlulwe "," ezixubeneyo "ze-mucus" ezixubeneyo ". Inkcazo ye-gustric kunye ne-mucuns ye-gestinaal ibizwa ngokuba yi-phenotype hayi indawo ethile ye-anatomical yendawo yesisu kunye namathumbu.
Kukho ii-phenotypes ezine ze-pheturs ze-gestric tumum Amathumba awenzeka kwisiseko se-metaplasia ye-metapilia ye-gestrointentinal exubeneyo. Iintshaba ezahlukileyo zibonisa uhlobo lwamathumbu (i-MUC2 +), kwaye i-Direclors Ibonisa uhlobo lwe-gestric ikakhulu (iMuc5Ac +, muc6 +).
Ukuchonga okungalunganga kufuna indibaniselwano ethile yeendlela zokufumana ezininzi zokufunyanwa kwesigqibo esibanzi. I-HP-I-HEM-ANGRINGRIC YAYONA NOKUSETYENZISWA KWE-DEMOSTRICY I-GEOSTIL YOBUCHULE BENKONZO YAMANZI. Ngolwazi malunga ne-X-ray ibonakalisa ubungqina bomhlaza we-HP-of Gpstric Umhlaza, nceda ujonge icandelo elichaphazelekayo "lesisu kunye nethuni".
I-2. I-Endoscopic ibonakalise ngomhlaza we-HP-on
Uxilongo lwe-Endoscopic lugxile kwi-HP-ne-HEATARY DOLORR. Ibandakanya i-Gast Gast Gastric Umhlaza we-GEASTAL umhlaza, i-Gestric Adeolar Epitial Epitial Tumor, i-SEPNERY FOIROR TOROR TUROR, i-SEPNERY FALCHICOR TUROROR TURORORTALY ERORCICY DOMOR.
1) Uhlobo lwe-FicC Gland Uhlanya lomhlaza
-Ukuphakamisa izilonda
Uhlobo lwe-FicC Gland Teest Umhlaza
Imeko yoku-1: I-White, I-Lesions ephakanyisiweyo
Inkcazelo:I-Gastric Fix ye-GuicTix ye-Guarlix ye-Guardix-enkulu ye-Cardia, i-10 mm, emhlophe, i-o-chart (ngaphandle), ngaphandle kwe-atrophysia okanye i-metapusia ye-atrophy okanye i-metapusia okanye ngaphandle kwe-atrophsia okanye i-metaplasia okanye i-metaplasia okanye i-metapilia okanye i-atrophy. Imithambo ye-Arbor-njengeemitha zegazi inokubonwa kumphezulu (i-NBI kunye nokwandisa kancinci)
UQOQOSHOU, O-1LA, 9mm, uFundc Gland Uhlanya lomhlaza, i-PT1B / SM2 (I-ULO, LY0, VMO, VMO, VMO, VMO
-Izilo
Uhlobo lwe-FicC Gland Teest Umhlaza
Imeko yesi-2: I-White, iFlet / iflethi
Inkcazelo:Udonga lwangaphandle lwe-Gastric Fuftix-Carvia Grag, i-14 mm, imhlophe, uhlobo lwe-0-16lC, ngaphandle kwemida ye-Toroph, kunye nemithambo yegazi, kunye nemithambo yegazi ebonakalayo kumphezulu. (I-NBI kunye ne-AMPLEATED)
UQOQOSHOI-U, i-0-ilc, i-14mm, i-fricy gland yomhlaza, i-PT1B / SM2 (I-ULO, LY0, VMO, VMO, VMO
-Ikhutshiwe izilonda
Uhlobo lwe-FicC Gland Teest Umhlaza
Imeko yesi-3: Ababomvu kwaye baphakamisa izilonda
Inkcazelo:Udonga olungaphandle lwe-curvature enkulu ye-Cardia yi-12 mm, ngokucacileyo ibomvu, uhlobo lwe-0-1, ngaphandle kwemida ye-0-1, ngaphandle kwemida yegazi, kunye ne-gestalias, kunye ne-genas
UQOQOSHOU, 0-1, 12mm, uFundlic Gland Umhlaza we-Gastric Umhlaza, i-PT1B / SM1 (ULO, LYO, VMO, VMO, VMO, VMO, VMO, VMO, VMO, VMO
-I--red, iflethi, edandathekileyos
Uhlobo lwe-FicC Gland Teest Umhlaza
Imeko yesi-4: Bomvu, iflethi / i-ced / yoxinzelelo
Inkcazelo:I-posteringar yodonga lwe-curvature enkulu yenxalenye yomzimba ye-gestric, i-18mm, uhlobo lwe-o-1m, i-o-1m ye-o-1ic, i-metarilia engacacanga, (i-metary yomda wegazi, (i-gestarical yomda,
UQOQOSHOU, O-1lC, i-19mm, i-Gtcric Gland yomhlaza, pt1b / i-PT1B / i-PT1B / i-PT1B / i-v1 (i-Ulo, i-LO, VMO, VMO
Xoxa
Amadoda anesi sifo mdala kunabafazi, ngomxholo ophakathi uneminyaka engama-67.7 ubudala. Ngenxa yeempawu zotywala ngamanye amaxesha kunye ne-heterochrony, izigulana ezifunyaniswa zinohlobo lwe-fric gland yomhlaza kufuneka iphononongwe kube kanye ngonyaka. Esona sithuba sixhaphakileyo yindawo ye-Ficland ye-Ficland embindini kunye nenxalenye ephezulu yesisu (i-russus kunye nendawo ephakathi kunye nenqanaba eliphezulu lomzimba wegadi). I-SMT emhlophe-njengama-smt ephakanyisiweyo ixhaphake kakhulu ekukhanyeni okumhlophe. Olona nyango luphambili kukuxilongwa kwe-EMR / i-ESD.
Akukho mephuric ye-lymphatic okanye i-vascular casion iboniwe ukuza kuthi ga ngoku. Emva konyango, kuyimfuneko ukufumanisa ukuba wenza ukuba enze utyando olongezelelweyo kwaye ahlole ubudlelwane phakathi kwemeko engalunganga kunye ne-HP. Ayisiyo yonke i-fric gland-chwetheza umhlaza we-gestric yi-HP.
1) I-FicC Gland Mucosal Gastric Carer
I-Ficc Gland Mucosal Gastric Carer
Imeko 1
Inkcazelo:I-lession iphakanyisiwe kancinane, kwaye i-rac engeyiyo i-racric mucosa inokubonwa ijikeleze. Ukutshintsha ngokukhawuleza kwemilukwano kunye namantshontsho kunokubonwa kwinxalenye ye-M-bi, kwaye i-DL ingabonwa.
UQOQOSHOI-Guctic Gland Mucosal Cancer, I-One, i-0-16mm, Pt1a / i-PT1A / PT1
I-Ficc Gland Mucosal Gastric Carer
Imeko 2
Inkcazo: I-lesion yeflethi kudonga olungaphandle lwe-andler curvature ye-Cardia, nge-fition witment kunye nemithambo yegazi, kwaye i-lesion iphakanyisiwe kancinci.
Isifo (sidityaniswe ne-pathology): I-Gynic Gland Mucosal Umhlaza we-Gastric, 0-LLA, pt1a / m, ulo, i-llov0, hm0, vmo
Xoxa
Igama le "Gastric Gland Mucosal Adenocarcinoma" kunzima ukubiza, kwaye inqanaba le-vent liphantsi kakhulu. Ifuna iinzame ezingakumbi zokwamkela kwaye ziyiqonde. I-Ficc Gland Mucosal Adenocarcinoma ineempawu zobukhulu obuphezulu.
Kukho iimpawu ezine eziphambili ze-endoscopy ye-goscopy: ② sumor tumar smt; I-Delitritic Denditric Squalis; ④ I-MicroPartecles yeNgingqi. Intsebenzo Sebenzisa inkqubo ye-MESDA-G ecetyiswayo, i-90% ye-FicTic Gland Mucosal Grassics ihlangabezane neekhrayitheriya zokuxilonga.
3) I-Gestric Adenoma (Pyloric Glenoma Pganoma pga)
I-Gastric Adenoma
Imeko 1
Inkcazelo:I-lesion emhlophe ephakanyisiweyo ibonakale kudonga lwasemva kwendawo ye-Gastric Disnix enemida engacacanga. I-Indigo Carming Staing ayikhange ibonakale mida icacileyo, kwaye imbonakalo ye-LST-ge-njenge-LST-AFS yethumbu ye-LSTE ibonwa (yandiswa kancinci).
UQOQOSHOI-Atypia ye-Atypia ye-carcoma, o-1LA, 47 * 32mm, i-tubular ye-tubular adenova, pt1a / m, u-ly0, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo, vmo.
I-Gastric Adenoma
Imeko 2
Inkcazo: I-leson ephakanyisiweyo inamaqhuqhuva kudonga olungaphandle lwenxalenye ephakathi yomzimba ophakathi. I-Gastritis esebenzayo inokubonwa ngasemva. I-Indigo Carmine inokubonwa njengomda. (I-nbi kunye nokukhulisa kancinci)
I-pathology: I-muc5ac ibonakaliswe kwi-opiticial epitiriya, kwaye i-MUCD6 ibonwa kwi-opiticial epiticial epiticial. Isifo sokugqibela se-PGA.
Xoxa
I-Adenomy Adonoss ziyi-Gucinous Glounds ingena kwiscroma kwaye igutyungelwe yiFroveolar Epilium. Ngenxa yokwanda kwe-Glaller Primposions, engu-hemispherical okanye i-hemisfar, i-addenos ye-guscopic ukukhanya kwaye kukukhupha. Kuyimfuneko ukunikela ingqalelo kuhambo olu-4 lwe-jiu ming phantsi koviwo lwe-endoscopic. I-I-NBI inokujonga i-paprillary ye-PGGA / inkanuko ye-PGA. I-PGA ayisiyo ngokupheleleyo i-HP engathandekiyo nengathandekiyo, kwaye inomngcipheko othile womhlaza. Ukuxilongwa kwangoko kunye nonyango lwakwangoko kugxothiwe, kwaye emva kokufunyanwa, ukuqhubela phambili kwe-Bloc esebenzayo, kwaye kuyacetyiswa isifundo esineenkcukacha.
I-4) (i-raspberry-i-on) i-foveolar epithelial gostric umhlaza
I-raspberriry foveolar epitise ye-gustric dorgar
Imeko 2
Inkcazelo:(ishiyekile)
Isifo (sidityaniswe ne-pathology): I-Foveolar epithelial Gastric Carer
I-raspberriry foveolar epitise ye-gustric dorgar
Imeko yesi-3
Inkcazelo:(ishiyekile)
UQOQOSHOI-Foveolar epitise ye-guritic dorar
Xoxa
I-raspberry, ebizwa ngokuba ngu "Tuobai'er" kwidolophu yethu, sisiqhamo sasendle ecaleni kwendlela xa sasisengabantwana. I-Gandlandwarlium ye-Gandlearlium kunye namabala axhunyiwe, kodwa ayingomxholo omnye. Kuyimfuneko ukuqondakala iimpawu zokukhula kunye nophuhliso lweeseli ezichazayo. I-raspberbertial epithelial gestlic dorar ifana kakhulu neepokheli ze-gestric kwaye inokuphazamiseka ngokulula kwi-polyps egudileyo. Inqaku le-rovesolar epitium yeyona ndlela iphambili ye-muc5ac. Ke iFoveolar epiklial CarCinoma yikota eqhelekileyo kolu hlobo. Inokubakho kwi-HP engathandekiyo, eyakhayo, okanye emva kobisi. Imbonakalo ye-endoscopic: I-Strawd Strawberry ebomvu-efana ne-bulge, ngokubanzi inemida ecacileyo.
I-5) I-SIGNET CARCINA
I-SIGNET I-CARCINA I-CarCinoma: Imbonakalo emhlophe
I-SIGNET I-CARCINA I-CarCinoma: Imbonakalo emhlophe
I-SIGNET I-TARCINA YOKUGQIBELA
Imeko 1
Inkcazelo:I-lesion yeflethi eludongeni lwasemva kwe-postric Vestibule, i-10 mm, iphelelwe lixesha, i-me-vide: I-IMVP (i-IMSP ()
UQOQOSHOI-ESD IIMPAWU ZOKUSETYENZISWA KOKUFUMANEKA KWE-SIGNET SCIGNAse CarCinoma.
Ukubonakaliswa kwe-pathological
I-SIGNET I-TARCINA I-CarCinoma yeyona ndlela ibalaseleyo. Ngokutsho kwe-Lauren Clousiation, i-gestic suring ye-sccinoma ihlelwe njengohlobo lwe-carcinoma kwaye luhlobo lwe-carcinoma ongathathi ntweni. Ihlala yenzeka emzimbeni wesisu, kwaye ixhaphake kakhulu kwizilonda zeflethi nezezisu kunye nethoni edikiweyo. Izilonda eziphakanyisiweyo zinqabile kwaye zinokubonakalisa njengokhokelo okanye izilonda. Kunzima ukufumana kuvavanyo lwe-endoscopic kumanqanaba okuqala. Unyango lunokuba luhlaselwano olukhuselekileyo olunjenge-endoscopic e-Endoscopic e-Esd, ngokulandelelana okungqongqo kunye nokuvavanywa kokwenza utyando olongezelelekileyo. Ukutshatiswa okungalawulekiyo kufuneka kufuna utyando olongezelelweyo, kwaye indlela yoqhaqho igqitywe ngugqirha wotyando.
Le ntetho yomyalezo ingentla kunye nemifanekiso ivela "sisisu kunye namathumbu"
Ukongeza, ingqalelo kufuneka ihlawulwe kwi-esophagogastric yomhlaza, umhlaza we-Cardia, kunye ne-Adenocarcinoma eyahlukileyo efumaneka kwimvelaphi ye-HP-ne-HP.
3. Isishwankathelo
Namhlanje ndifunde ulwazi olufanelekileyo kunye ne-endoscopic vesmores yomhlaza we-HP-of Gestric Carec. Kuquka ne-Ficlic Gland yohlobo lwe-Gastric Umhlaza we-Gucosal Umhlaza we-Gastric Caric Adric Careric Capitial Epitial Tumor kunye ne-SIGNET CARINEA.
Imeko yeklinikhi yomhlaza we-HP-of Gp-One kakuhle iphantsi, kunzima ukugweba, kwaye kulula ukuphosa ukuxilongwa. Yintoni enzima nangakumbi ibonakalisa i-endoscopic ye-endoscopic yezifo ezinzima nezinqabileyo. Ifanele iqondwe kwimeko entle ye-tooscopic, ngakumbi ulwazi lwethiyori emva kwayo.
Ukuba ujonga i-gestric Polyps, ukhukuliseko, kunye neendawo ezibomvu kunye ezimhlophe, kuya kufuneka uqwalasele ukubakho komhlaza we-HP-of Gastric Draler. Umgwebo we-HP ongenayo kufuneka athobele imigangatho, kwaye kuthathelwe ingqalelo kufuneka ihlawulwe kwizinto eziphosakeleyo ezibangelwa kukuxhomekeka kakhulu kwiziphumo zovavanyo lokuphefumla. Amanqindi abo anamava athembela ngamehlo abo ngakumbi. Ukujongana nethiyori eneenkcukacha emva komhlaza we-HP-oversic umhlaza, kufuneka siqhubeke sifunda, siqonde kwaye siziqhelanise nokuyifumana.
Thina, iJiangxi Zhuoruhiuuuuuuuhui-biopsy godps, i-hemoclip, I-Polyp gorare, Inaliti ye-sclerotherapy, Ukutshiza kwe-catheter, Ibrashi ye-cytology,isikhokelo,Ibhasikithi yokubuyisa ilitye, I-Nasal Biling Draheter Catheter catheter njl. ezisetyenziswe ngokubanzi ngaphakathiEMR,Esd,I-ERCP.Iimveliso zethu kufuneka ziqinisekiswe, kwaye izityalo zethu ziqinisekisiwe. Impahla yethu ithunyelwe eYurophu, iMntla Melika, eMbindi Mpuma kunye nenxalenye yeAsia, kwaye ifumana umthengi wokuqonda kunye nokudumisa!
Ixesha lokuphumla: Jul-12 ukuya ku-524