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

Ma waena o ka ʻike kaulana e pili ana i ka maʻi maʻi ʻaʻai mua, aia kekahi mau wahi ʻike maʻi kakaʻikahi e pono ai ka nānā a me ke aʻo ʻana.ʻO kekahi o lākou ʻo ka maʻi maʻi ʻōpū HP-negative.ʻOi aku ka kaulana o ka manaʻo o "uninfected epithelial tumors".E ʻokoʻa nā manaʻo e pili ana i ka pili inoa.Hoʻokumu ʻia kēia kumumanaʻo ma luna o nā ʻike pili i ka makasina "Stomach and Intestine", a hoʻohana pū ka inoa i ka "HP-negative gastric cancer".

Loaʻa i kēia ʻano lesion nā hiʻohiʻona o ka haʻahaʻa haʻahaʻa, paʻakikī i ka ʻike ʻana, paʻakikī ʻike theoretical, a ʻaʻole pili ke kaʻina MESDA-G maʻalahi.Pono ke aʻo ʻana i kēia ʻike i ke alo i nā pilikia.

1. ʻIke kumu o ka maʻi ʻōpū o ka HP-negative

Moolelo

I ka wā ma mua, ua manaʻo ʻia ʻo ka mea hewa hoʻokahi i ka hanana a me ka ulu ʻana o ka maʻi maʻi ʻōpū ʻo ia ka maʻi HP, no laila ʻo ke kumu hoʻohālike maʻamau ʻo HP - atrophy - intestinal metaplasia - haʻahaʻa haʻahaʻa - kiʻekiʻe kiʻekiʻe - canceration.Ua ʻike nui ʻia ke ʻano maʻamau, ʻae ʻia a hilinaʻi paʻa.Hoʻoulu pū ʻia nā ʻōpū ma ke kumu o ka atrophy a ma lalo o ka hana a HP, no laila ulu nui nā maʻi maʻi i loko o nā ʻāpana ʻōpū atrophic a emi ʻole ka maʻamau non-atrophic gastric mucosa.

Ma hope mai, ua ʻike kekahi mau kauka hiki ke loaʻa ka maʻi maʻi ʻōpū me ka loaʻa ʻole o ka maʻi HP.ʻOiai he haʻahaʻa loa ka nui o ka hihia, hiki nō.Kapa ʻia kēia ʻano maʻi maʻi ʻōpū o ka HP-negative gastric cancer.

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

Nā ʻano Gland a me nā ʻano ulu

Aia ʻelua ʻano nui o nā ʻili kālā a me nā ʻili pyloric i ka ʻōpū:

Hoʻokaʻawale ʻia nā ʻili kālā (oxyntic glands) i loko o ka waihona, ke kino, nā kihi, a me nā mea ʻē aʻe o ka ʻōpū.ʻO lākou nā ʻāʻī tubular linear.Hoʻokumu ʻia lākou me nā pūnaewele mucous, nā pūnaewele nui, nā ʻāpana parietal a me nā pūnaeho endocrine, e hana ana kēlā me kēia i kā lākou mau hana ponoʻī.Ma waena o lākou, nā pūnaewele poʻokela Ua maikaʻi ka hoʻopaʻa ʻana o ka PGI a me MUC6 i huna ʻia, a ua huna nā pūnaetal parietal i ka waika hydrochloric a me ka intrinsic factor;

Aia nā puʻupuʻu pyloric i loko o ka ʻāpana antrum o ka ʻōpū a ua haku ʻia me nā pūnaewele mucus a me nā cell endocrine.ʻO nā pūnaewele mucus he MUC6 maikaʻi, a ʻo nā pūnaeho endocrine e komo pū me nā pūnaewele G, D a me nā cell enterochromaffin.Hoʻokuʻu nā pūnaewele G i ka gastrin, huna nā pūnaewele D i ka somatostatin, a huna nā pūnaewele enterochromaffin i ka 5-HT.

ʻO nā pūnaewele mucosal maʻamau a me nā pūnaewele tumora e hūnā i nā ʻano like ʻole o nā protein mucus, i māhele ʻia i "gastric", "intestinal" a me "mixed" mucus proteins.Kapa ʻia ka ʻōlelo o ka ʻōpū a me ka ʻōpū o ka ʻōpū he phenotype a ʻaʻole ka wahi anatomical kikoʻī o ka ʻōpū a me ka ʻōpū.

He ʻehā mau ʻano ʻano o ka ʻōpū o ka ʻōpū: piha ka ʻōpū, ka ʻōpū-dominant i hui ʻia, ka ʻōpū-dominant i hui pū ʻia, a me ka ʻōpū loa.ʻO nā puʻupuʻu i loaʻa ma ke kumu o ka metaplasia intestinal ka hapa nui o nā maʻi maʻi phenotype i hui pū ʻia.Hōʻike nui nā maʻi maʻi maʻi ʻokoʻa i ke ʻano o ka ʻōpū (MUC2+), a ʻo nā maʻi maʻi diffuse e hōʻike nui i ke ʻano ʻōpū (MUC5AC+, MUC6+).

Pono ka hoʻoholo ʻana i ka Hp ʻino i kahi hui kikoʻī o nā ʻano ʻike he nui no ka hoʻoholo piha.ʻO ka maʻi maʻi ʻōpū HP-negative a me ka maʻi ʻōpū ma hope o ka sterilization ʻelua mau manaʻo like ʻole.No ka ʻike e pili ana i nā hōʻike X-ray o ka HP-negative gastric cancer, e ʻoluʻolu e nānā i ka ʻāpana kūpono o ka puke "Stomach and Intestine".

2. Nā hōʻike endoscopic o HP-negative gastric cancer

ʻO ka hōʻailona Endoscopic ke kumu o ka HP-negative gastric cancer.Hoʻopili nui ia i ka maʻi maʻi ʻōpū o ka ʻōpū, ka maʻi maʻi ʻāʻī o ka ʻōpū, ka adenoma o ka ʻōpū, ka maʻi ʻōpū epithelial foveolar, ka maʻi maʻi pūlima pūlima, a me nā mea ʻē aʻe.

1) Ka maʻi ʻaʻai ʻōpū o ka ʻōpū kālā

-ʻO nāʻeha keʻokeʻo i hāpaiʻia