He paʻakikī ke ʻike i kēia ʻano maʻi ʻōpū, no laila e makaʻala i ka wā endoscopy!

Ma waena o ka ʻike kaulana e pili ana i ka maʻi ʻōpū mua, aia kekahi mau kiko ʻike maʻi laha ʻole e pono ai ka nānā kūikawā a me ke aʻo ʻana. ʻO kekahi o lākou ka maʻi ʻōpū HP-negative. ʻOi aku ka kaulana o ke kumumanaʻo o "nā ʻōpū epithelial i hoʻopili ʻole ʻia". E loaʻa nā manaʻo like ʻole e pili ana i ka pilikia inoa. Hoʻokumu nui ʻia kēia kumumanaʻo ʻike ma ka ʻike e pili ana i ka makasina "Stomach and Intestine", a hoʻohana pū ka inoa i ka "HP-negative gastric cancer".

ʻO nā ʻano o kēia ʻano ʻeha he haʻahaʻa ka nui, paʻakikī i ka ʻike ʻana, ʻike kumumanaʻo paʻakikī, a ʻaʻole pili ke kaʻina hana MESDA-G maʻalahi. ʻO ke aʻo ʻana i kēia ʻike e pono ai ke alo i nā pilikia.

1. ʻIke kumu o ka maʻi ʻōpū HP-negative

Moʻolelo

I ka wā ma mua, ua manaʻoʻiʻo ʻia ʻo ke kumu hoʻokahi i ka hanana a me ka ulu ʻana o ka maʻi ʻōpū ʻo ia ka maʻi HP, no laila ʻo ke kumu hoʻohālike maʻamau o ka maʻi kanesa ʻo HP - atrophy - intestinal metaplasia - low tumor - high tumor - canceration. Ua ʻike nui ʻia ke kumu hoʻohālike maʻamau, ʻae ʻia a manaʻoʻiʻo paʻa ʻia. Hoʻomohala pū nā puʻupuʻu ma ke kumu o ka atrophy a ma lalo o ka hana a HP, no laila ulu nui nā maʻi kanesa i nā ʻāpana ʻōpū atrophic a me ka mucosa gastric non-atrophic maʻamau.

Ma hope mai, ua ʻike kekahi mau kauka hiki ke loaʻa ka maʻi ʻōpū me ka ʻole o ka maʻi HP. ʻOiai he haʻahaʻa loa ka nui o ka hanana, hiki nō ia. Ua kapa ʻia kēia ʻano maʻi ʻōpū he maʻi ʻōpū HP-negative.

Me ka hoʻomaopopo mālie ʻana i kēia ʻano maʻi, ua hoʻomaka ʻia nā nānā hohonu a me nā hōʻuluʻulu manaʻo, a ke loli mau nei nā inoa. Aia kekahi ʻatikala i ka makahiki 2012 i kapa ʻia ʻo "Gastric Cancer after Sterilization", kahi ʻatikala i ka makahiki 2014 i kapa ʻia ʻo "HP-negative Gastric Cancer", a me kahi ʻatikala i ka makahiki 2020 i kapa ʻia ʻo "Epithelial Tumors Not Infected with Hp". Hōʻike ka hoʻololi inoa i ka hoʻomaopopo hohonu a piha.

Nā ʻAno Gland a me nā ʻAno Ulu

Aia ʻelua ʻano nui o nā kelepa fundic a me nā kelepa pyloric i loko o ka ʻōpū:

Hoʻolaha ʻia nā kelepa fundic (nā kelepa oxyntic) ma ka fundus, ke kino, nā kihi, a me nā mea ʻē aʻe o ka ʻōpū. He mau kelepa tubular linear hoʻokahi lākou. Hana ʻia lākou me nā cell mucous, nā cell chief, nā cell parietal a me nā cell endocrine, kēlā me kēia e hana i kā lākou mau hana ponoʻī. I waena o lākou, nā cell chief Ua maikaʻi ka hoʻoluʻu ʻana o PGI a me MUC6, a ua hoʻokuʻu nā cell parietal i ka waikawa hydrochloric a me ka intrinsic factor;

Aia nā kelepa pyloric ma ka ʻāpana antrum gastric a ua haku ʻia me nā pūnaewele mucus a me nā pūnaewele endocrine. He MUC6 maikaʻi nā pūnaewele Mucus, a ʻo nā pūnaewele endocrine e komo pū ana me nā pūnaewele G, D a me nā pūnaewele enterochromaffin. Hoʻopuka nā pūnaewele G i ka gastrin, hoʻopuka nā pūnaewele D i ka somatostatin, a hoʻopuka nā pūnaewele enterochromaffin i ka 5-HT.

Hoʻopuka nā pūnaewele mucosal gastric maʻamau a me nā pūnaewele tumor i nā ʻano protein mucus like ʻole, i māhele ʻia i nā protein mucus "gastric", "intestinal" a me "mixed". ʻO ka hōʻike ʻana o nā mucins gastric a me nā intestinal i kapa ʻia he phenotype a ʻaʻole ke wahi anatomical kikoʻī o ka ʻōpū a me nā ʻōpū.

ʻEhā ʻano o nā cell tumors o ka ʻōpū: ʻōpū piha, ʻōpū-dominant i hui pū ʻia, ʻōpū-dominant i hui pū ʻia, a me ka ʻōpū piha. ʻO nā tumors e kū mai ana ma ke kumu o ka metaplasia ʻōpū, ʻo ia ka hapa nui o nā tumors phenotype i hui pū ʻia me ka ʻōpū. Hōʻike nui nā maʻi kanesa i hoʻokaʻawale ʻia i ke ʻano ʻōpū (MUC2+), a hōʻike nui nā maʻi kanesa diffuse i ke ʻano ʻōpū (MUC5AC+, MUC6+).

ʻO ka hoʻoholo ʻana i ka Hp negative e pono ai kahi hui kūikawā o nā ʻano ʻike he nui no ka hoʻoholo piha ʻana. ʻO ke kanesa ʻōpū HP-negative a me ke kanesa ʻōpū post-sterilization he ʻelua mau manaʻo like ʻole. No ka ʻike e pili ana i nā hōʻike X-ray o ke kanesa ʻōpū HP-negative, e ʻoluʻolu e nānā i ka ʻāpana pili o ka makasina "Stomach and Intestine".

2. Nā hōʻike endoscopic o ka maʻi ʻōpū HP-negative

ʻO ka ʻike endoscopic ke kikowaena o ka maʻi ʻōpū HP-negative. ʻO ia hoʻi ka maʻi ʻōpū fundic type gland, fundic gland mucosal type gastric cancer, gastric adenoma, raspberry foveolar epithelial tumor, signet ring cell carcinoma, a me nā mea ʻē aʻe. Ke nānā nei kēia ʻatikala i nā hōʻike endoscopic o ka maʻi ʻōpū HP-negative.

1) Ka maʻi maʻi ʻōpū o ka ʻōpū kālā

-Nā ʻeha keʻokeʻo i hoʻāla ʻia