Article(id=1322934768572171110, tenantId=1146029695717560320, journalId=1319373162502258839, issueId=1322934653228822704, articleNumber=null, orderNo=null, doi=10.16016/j.2097-0927.202409149, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1727366400000, receivedDateStr=2024-09-27, revisedDate=1735228800000, revisedDateStr=2024-12-27, acceptedDate=null, acceptedDateStr=null, onlineDate=1793341827766, onlineDateStr=2026-10-30, pubDate=1741968000000, pubDateStr=2025-03-15, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793341827766, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793341827766, creator=13701087609, updateTime=1793341827766, updator=13701087609, issue=Issue{id=1322934653228822704, tenantId=1146029695717560320, journalId=1319373162502258839, year='2025', volume='47', issue='5', pageStart='385', pageEnd='488', issueExtLink='null', onlineDate='null', pubDate='1741968000000', pubDateStr='2025-03-15', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793341800267, creator='13701087609', updateTime=1793341800267, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=407, endPage=416, ext={EN=ArticleExt(id=1322934768765109095, articleId=1322934768572171110, tenantId=1146029695717560320, journalId=1319373162502258839, language=EN, title=Diagnostic value of endoscopic LCPL sign for high-risk intestinal metaplasia in gastric mucosa, columnId=1320442291748192970, journalTitle=Journal of Army Medical University, columnName=Monographic Reports, runingTitle=null, highlight=null, articleAbstract=
Objective‍

To investigate the diagnostic value of endoscopic sign of light blue crest (LBC) capsuling papillary lesion (LCPL) for high-risk intestinal metaplasia (IM).

Methods‍

A total of 314 patients (352 biopsy specimens) who underwent endoscopic examination and biopsy in Department of Gastroenterology of Army Medical Center of PLA from January 2021 to June 2023 were recruited, and HE and HID-AB staining (the golden standard of high-risk IM) were apllied to detect the histological types and IM types. The samples were subsequently divided into chronic inflammation group, low-risk IM group, high-risk IM group, well-differentiated intestinal-type gastric cancer group, and poorly-differentiated intestinal-type gastric cancer group. The positive rate of LCPL in each group and its diagnostic efficacy were analyzed based on endoscopic images of the biopsy sites. Logistic regression analysis was used to investigate the relationship between LCPL sign and high-risk IM, as well as the clinical and pathological features associated with LCPL sign. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficacy of LCPL for high-risk IM, using indicators such as sensitivity, specificity, Youden index and area under the curve (AUC).

Results‍

The positive rate of the LCPL sign in high-risk IM group was 75.70%, significantly higher than that of the other groups (all P<0.001). Logistic regression analysis showed that LCPL sign was significantly correlated with high-risk IM (OR=30.286, 95%CI: 13.528~67.804, P<0.001). When the sign was employed in diagnosing high-risk IM, the sensitivity was 69.84%, the specificity was 93.75%, the Youden’s index was 0.636, and the AUC value was 0.818 (95%CI: 0.773~0.857). Besides sensitivity, all above parameters of LCPL sign showed significantly better diagnostic efficacy than those of traditional LBC sign, which is used as a sign for diagnosing IM (P<0.001). Moreover, recognition of LCPL sign was not easily affected by age (OR=1.130, 95%CI: 0.709~1.800, P=0.607), lesion site (Angular incisure: OR=2.360, 95%CI: 0.732~7.613, P=0.151; Autrum: OR=2.257, 95%CI: 0.756~6.744, P=0.145), and presence of peptic ulcers (OR=1.085, 95%CI: 0.208~5.652, P=0.923). Significantly, 94.12% of positive and 66.94% of negative LCPL signs could be rapidly recognized within 3 s (OR=4.536, 95%CI: 1.372~14.997, P=0.013).

Conclusion‍

LCPL sign shows high efficacy and potential clinical application value for high-risk IM in gastric mucosa of endoscopic diagnosis.

, authors=Xipeng ZHENG1, Huilin PAN1, Linyu WU1, Yongying HOU2, Qin LIU1, Qiang MA2, Xiuyuan QIN3, Kaijun LIU1, Bin WANG1, Dongfeng CHEN1, Tao WANG1, authorsList=Xipeng ZHENG, Huilin PAN, Linyu WU, Yongying HOU, Qin LIU, Qiang MA, Xiuyuan QIN, Kaijun LIU, Bin WANG, Dongfeng CHEN, Tao WANG, authorCompany=null, correspAuthors=Tao WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=© 2025 Journal of Army Medical University, copyrightOwner=Editorial Office of Journal of Army Medical University, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322934771189416816, articleId=1322934768572171110, tenantId=1146029695717560320, journalId=1319373162502258839, language=CN, title=内镜下LCPL征象对胃黏膜高危肠上皮化生的诊断价值, columnId=1322190423666315871, journalTitle=陆军军医大学学报, columnName=专题报道, runingTitle=null, highlight=null, articleAbstract=
目的

探讨内镜下亮蓝嵴(light blue crest,LBC)包绕的乳头状区域(LBC capsuling papillary lesion,LCPL)征象在高危胃黏膜肠上皮化生(intestinal metaplasia,IM,简称“肠化”)中的诊断价值。

方法

选取2021年1月至2023年6月在陆军特色医学中心消化内科接受内镜检查及活检的314例患者(共352块活检样本)。采用HE染色及高铁二胺-阿尔新蓝(high iron diamine-alcian blue,HID-AB)染色(诊断高危肠化的金标准)检查样本的组织学类型及肠化类型,并据此将样本分为慢性炎症组、低危肠化组、高危肠化组、高-中分化肠型胃癌组、低分化肠型胃癌组。结合活检部位内镜下图像,统计分析LCPL在各组中的阳性率;采用Logistic回归分析LCPL征象与高危肠化的关系,以及与LCPL相关的临床病理特征;采用灵敏度、特异度、约登指数、受试者工作曲线下面积等指标,评价LCPL对高危肠化的诊断效能。

结果

LCPL征象在高危肠化组的阳性率达75.70%,显著高于其他各组(P均<0.001);Logistic回归分析显示LCPL与高危肠化密切相关(OR=30.286,95%CI:13.528~67.804,P<0.001)。LCPL征象诊断高危肠化的灵敏度为69.84%、特异度为93.75%、约登指数为0.636、曲线下面积为0.818(95%CI:0.773~0.857);除灵敏度指标外,上述各诊断效能参数均显著优于诊断肠化与否的传统内镜下征象LBC(P均<0.001)。并且,LCPL征象的判别不易受到患者年龄(OR=1.130,95%CI:0.709~1.800,P=0.607)、病变部位(胃角:OR=2.360,95%CI:0.732~7.613,P=0.151;胃窦:OR=2.257,95%CI:0.756~6.744,P=0.145)、是否合并消化性溃疡(OR=1.085,95%CI:0.208~5.652,P=0.923)等因素的影响;94.12%的阳性、66.94%的阴性LCPL征象可在3 s内被快速识别(OR=4.536,95%CI:1.372~14.997,P=0.013)。

结论

内镜下LCPL征象在诊断胃黏膜高危肠化中有较好效能,具有潜在临床应用价值。

, authors=郑喜鹏1, 潘惠琳1, 吴林育1, 侯永英2, 刘琴1, 马强2, 秦修远3, 刘凯军1, 王斌1, 陈东风1, 王涛1, authorsList=郑喜鹏, 潘惠琳, 吴林育, 侯永英, 刘琴, 马强, 秦修远, 刘凯军, 王斌, 陈东风, 王涛, authorCompany=null, correspAuthors=王涛, authorNote=null, correspAuthorsNote=
王 涛,E-mail:
WANG Tao,E-mail:
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tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1016/j.jncc.2024.01.006, pmid=null, pmcid=null, year=2024, volume=4, issue=1, pageStart=47, pageEnd=53, url=null, language=null, rfNumber=1, rfOrder=0, authorNames=HAN B F, ZHENG R S, ZENG H M, journalName=J Natl Cancer Cent, refType=null, unstructuredReference=HAN B F,ZHENG R S,ZENG H M,et al. Cancer incidence and mortality in China,2022[J]. J Natl Cancer Cent,2024,4(1):47-53., articleTitle=Cancer incidence and mortality in China,2022, refAbstract=null), Reference(id=1322934778328122310, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1007/s10120-017-0716-7, pmid=null, pmcid=null, year=2018, volume=21, issue=1, pageStart=144, pageEnd=154, url=null, language=null, rfNumber=2, rfOrder=1, authorNames=KATAI H, ISHIKAWA T, AKAZAWA K, journalName=Gastric Cancer, refType=null, unstructuredReference=KATAI H,ISHIKAWA T,AKAZAWA K,et al. Five-year survival analysis of surgically resected gastric cancer cases in Japan:a retrospective analysis of more than 100 000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001-2007)[J]. Gastric Cancer,2018,21(1):144-154., articleTitle=Five-year survival analysis of surgically resected gastric cancer cases in Japan:a retrospective analysis of more than 100 000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001-2007), refAbstract=null), Reference(id=1322934779976483784, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1007/s10120-016-0659-4, pmid=null, pmcid=null, year=2017, volume=20, issue=Suppl 1, pageStart=20, pageEnd=27, url=null, language=null, rfNumber=3, rfOrder=2, authorNames=SUMIYAMA K, journalName=Gastric Cancer, refType=null, unstructuredReference=SUMIYAMA K. Past and current trends in endoscopic diagnosis for early stage gastric cancer in Japan[J]. Gastric Cancer,2017,20(Suppl 1):20-27., articleTitle=Past and current trends in endoscopic diagnosis for early stage gastric cancer in Japan, refAbstract=null), Reference(id=1322934780051981258, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=null, pmid=null, pmcid=null, year=1992, volume=52, issue=24, pageStart=6735, pageEnd=6740, url=null, language=null, rfNumber=4, rfOrder=3, authorNames=CORREA P, journalName=Cancer Res, refType=null, unstructuredReference=CORREA P. Human gastric carcinogenesis:a multistep and multifactorial process—First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention[J]. Cancer Res,1992,52(24):6735-6740., articleTitle=Human gastric carcinogenesis:a multistep and multifactorial process—First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention, refAbstract=null), Reference(id=1322934780207170508, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1016/j.gie. 2016.04.028, pmid=null, pmcid=null, year=2016, volume=84, issue=4, pageStart=625, pageEnd=627, url=null, language=null, rfNumber=5, rfOrder=4, authorNames=HIGA J T, HWANG J H, journalName=Gastrointest Endosc, refType=null, unstructuredReference=HIGA J T,HWANG J H. Gastric intestinal metaplasia:an irreversible risk factor for gastric cancer?[J]. Gastrointest Endosc,2016,84(4):625-627., articleTitle=Gastric intestinal metaplasia:an irreversible risk factor for gastric cancer?, refAbstract=null), Reference(id=1322934780316222413, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1080/07357907.2019.1663207, pmid=null, pmcid=null, year=2019, volume=37, issue=9, pageStart=417, pageEnd=426, url=null, language=null, rfNumber=6, rfOrder=5, authorNames=TAHARA T, TAHARA S, HORIGUCHI N, journalName=Cancer Invest, refType=null, unstructuredReference=TAHARA T,TAHARA S,HORIGUCHI N,et al. Gastric mucosal microarchitectures associated with irreversibility with Helicobacter pylori eradication and downregulation of micro RNA (miR)-124a[J]. Cancer Invest,2019,37(9):417-426., articleTitle=Gastric mucosal microarchitectures associated with irreversibility with Helicobacter pylori eradication and downregulation of micro RNA (miR)-124a, refAbstract=null), Reference(id=1322934780626600910, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1053/j.gastro.2019.12.004, pmid=null, pmcid=null, year=2020, volume=158, issue=3, pageStart=745, pageEnd=750, url=null, language=null, rfNumber=7, rfOrder=6, authorNames=SHAH S C, GAWRON A J, MUSTAFA R A, journalName=Gastroenterology, refType=null, unstructuredReference=SHAH S C,GAWRON A J,MUSTAFA R A,et al. Histologic subtyping of gastric intestinal metaplasia:overview and considerations for clinical practice[J]. Gastroenterology,2020,158(3):745-750., articleTitle=Histologic subtyping of gastric intestinal metaplasia:overview and considerations for clinical practice, refAbstract=null), Reference(id=1322934780718875599, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1053/j.gastro.2021.10.036, pmid=null, pmcid=null, year=2022, volume=162, issue=2, pageStart=415, pageEnd=430, url=null, language=null, rfNumber=8, rfOrder=7, authorNames=GOLDENRING J R, MILLS J C, journalName=Gastroenterology, refType=null, unstructuredReference=GOLDENRING J R,MILLS J C. Cellular plasticity,reprogramming,and regeneration:metaplasia in the stomach and beyond[J]. Gastroenterology,2022,162(2):415-430., articleTitle=Cellular plasticity,reprogramming,and regeneration:metaplasia in the stomach and beyond, refAbstract=null), Reference(id=1322934780815344592, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1038/nrc.2017.68, pmid=null, pmcid=null, year=2017, volume=17, issue=10, pageStart=594, pageEnd=604, url=null, language=null, rfNumber=9, rfOrder=8, authorNames=GIROUX V, RUSTGI A K, journalName=Nat Rev Cancer, refType=null, unstructuredReference=GIROUX V,RUSTGI A K. Metaplasia:tissue injury adaptation and a precursor to the dysplasia-cancer sequence[J]. Nat Rev Cancer,2017,17(10):594-604., articleTitle=Metaplasia:tissue injury adaptation and a precursor to the dysplasia-cancer sequence, refAbstract=null), Reference(id=1322934781108945873, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1053/j.gastro.2019.12.003, pmid=null, pmcid=null, year=2020, volume=158, issue=3, pageStart=693, pageEnd=702, url=null, language=null, rfNumber=10, rfOrder=9, authorNames=GUPTA S, LI D, SERAG H B EL, journalName=Gastroenterology, refType=null, unstructuredReference=GUPTA S,LI D,SERAG H B EL,et al. AGA clinical practice guidelines on management of gastric intestinal metaplasia[J]. Gastroenterology,2020,158(3):693-702., articleTitle=AGA clinical practice guidelines on management of gastric intestinal metaplasia, refAbstract=null), Reference(id=1322934781184443346, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1055/a-0859-1883, pmid=null, pmcid=null, year=2019, volume=51, issue=4, pageStart=365, pageEnd=388, url=null, language=null, rfNumber=11, rfOrder=10, authorNames=PIMENTEL-NUNES P, LIBÂNIO D, MARCOS-PINTO R, journalName=Endoscopy, refType=null, unstructuredReference=PIMENTEL-NUNES P,LIBÂNIO D,MARCOS-PINTO R,et al. Management of epithelial precancerous conditions and lesions in the stomach (MAPS Ⅱ):European Society of Gastrointestinal Endoscopy (ESGE),European Helicobacter and Microbiota Study Group (EHMSG),European Society of Pathology (ESP),and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019[J]. Endoscopy,2019,51(4):365-388., articleTitle=Management of epithelial precancerous conditions and lesions in the stomach (MAPS Ⅱ):European Society of Gastrointestinal Endoscopy (ESGE),European Helicobacter and Microbiota Study Group (EHMSG),European Society of Pathology (ESP),and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019, refAbstract=null), Reference(id=1322934781251552211, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1053/j.gastro.2020.11.017, pmid=null, pmcid=null, year=2021, volume=160, issue=4, pageStart=1106, pageEnd=1117.e3, url=null, language=null, rfNumber=12, rfOrder=11, authorNames=PIAZUELO M B, BRAVO L E, MERA R M, journalName=Gastroenterology, refType=null, unstructuredReference=PIAZUELO M B,BRAVO L E,MERA R M,et al. The Colombian chemoprevention trial:20-year follow-up of a cohort of patients with gastric precancerous lesions[J]. Gastroenterology,2021,160(4):1106-1117.e3., articleTitle=The Colombian chemoprevention trial:20-year follow-up of a cohort of patients with gastric precancerous lesions, refAbstract=null), Reference(id=1322934781473850324, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1002/ijc.28003, pmid=null, pmcid=null, year=2013, volume=133, issue=5, pageStart=1023, pageEnd=1032, url=null, language=null, rfNumber=13, rfOrder=12, authorNames=GONZÁLEZ C A, SANZ-ANQUELA J M, GISBERT J P, journalName=Int J Cancer, refType=null, unstructuredReference=GONZÁLEZ C A,SANZ-ANQUELA J M,GISBERT J P,et al. Utility of subtyping intestinal metaplasia as marker of gastric cancer risk. A review of the evidence[J]. Int J Cancer,2013,133(5):1023-1032., articleTitle=Utility of subtyping intestinal metaplasia as marker of gastric cancer risk. A review of the evidence, refAbstract=null), Reference(id=1322934781545153493, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1055/s-2006-944632, pmid=null, pmcid=null, year=2006, volume=38, issue=8, pageStart=819, pageEnd=824, url=null, language=null, rfNumber=14, rfOrder=13, authorNames=UEDO N, ISHIHARA R, IISHI H, journalName=Endoscopy, refType=null, unstructuredReference=UEDO N,ISHIHARA R,IISHI H,et al. A new method of diagnosing gastric intestinal metaplasia:narrow-band imaging with magnifying endoscopy[J]. Endoscopy,2006,38(8):819-824., articleTitle=A new method of diagnosing gastric intestinal metaplasia:narrow-band imaging with magnifying endoscopy, refAbstract=null), Reference(id=1322934781612262358, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1055/s-0031-1291537, pmid=null, pmcid=null, year=2012, volume=44, issue=3, pageStart=236, pageEnd=246, url=null, language=null, rfNumber=15, rfOrder=14, authorNames=PIMENTEL-NUNES P, DINIS-RIBEIRO M, SOARES J B, journalName=Endoscopy, refType=null, unstructuredReference=PIMENTEL-NUNES P,DINIS-RIBEIRO M,SOARES J B,et al. A multicenter validation of an endoscopic classification with narrow band imaging for gastric precancerous and cancerous lesions[J]. Endoscopy,2012,44(3):236-246., articleTitle=A multicenter validation of an endoscopic classification with narrow band imaging for gastric precancerous and cancerous lesions, refAbstract=null), Reference(id=1322934781670982615, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1111/j.1523-5378.2012.00938.x, pmid=null, pmcid=null, year=2012, volume=17, issue=3, pageStart=224, pageEnd=231, url=null, language=null, rfNumber=16, rfOrder=15, authorNames=KANZAKI H, UEDO N, ISHIHARA R, journalName=Helicobacter, refType=null, unstructuredReference=KANZAKI H,UEDO N,ISHIHARA R,et al. Comprehensive investigation of areae gastricae pattern in gastric corpus using magnifying narrow band imaging endoscopy in patients with chronic atrophic fundic gastritis[J]. Helicobacter,2012,17(3):224-231., articleTitle=Comprehensive investigation of areae gastricae pattern in gastric corpus using magnifying narrow band imaging endoscopy in patients with chronic atrophic fundic gastritis, refAbstract=null), Reference(id=1322934781746480088, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1055/s-0043-103409, pmid=null, pmcid=null, year=2017, volume=49, issue=6, pageStart=529, pageEnd=535, url=null, language=null, rfNumber=17, rfOrder=16, authorNames=KANEMITSU T, YAO K S, NAGAHAMA T, journalName=Endoscopy, refType=null, unstructuredReference=KANEMITSU T,YAO K S,NAGAHAMA T,et al. Extending magnifying NBI diagnosis of intestinal metaplasia in the stomach:the white opaque substance marker[J]. Endoscopy,2017,49(6):529-535., articleTitle=Extending magnifying NBI diagnosis of intestinal metaplasia in the stomach:the white opaque substance marker, refAbstract=null), Reference(id=1322934781830366169, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1016/j.gie.2008.04.011, pmid=null, pmcid=null, year=2008, volume=68, issue=3, pageStart=574, pageEnd=580, url=null, language=null, rfNumber=18, rfOrder=17, authorNames=YAO K S, IWASHITA A, TANABE H, journalName=Gastrointest Endosc, refType=null, unstructuredReference=YAO K S,IWASHITA A,TANABE H,et al. White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow-band imaging:a new optical sign for differentiating between adenoma and carcinoma[J]. Gastrointest Endosc,2008,68(3):574-580., articleTitle=White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow-band imaging:a new optical sign for differentiating between adenoma and carcinoma, refAbstract=null), Reference(id=1322934781905863642, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1016/j.gie.2013.03.1333, pmid=null, pmcid=null, year=2013, volume=78, issue=3, pageStart=452, pageEnd=461, url=null, language=null, rfNumber=19, rfOrder=18, authorNames=HAYEE B, INOUE H, SATO H, journalName=Gastrointest Endosc, refType=null, unstructuredReference=HAYEE B,INOUE H,SATO H,et al. Magnification narrow-band imaging for the diagnosis of early gastric cancer:a review of the Japanese literature for the western endoscopist[J]. Gastrointest Endosc,2013,78(3):452-461., articleTitle=Magnification narrow-band imaging for the diagnosis of early gastric cancer:a review of the Japanese literature for the western endoscopist, refAbstract=null), Reference(id=1322934781981361115, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1111/jgh.16034, pmid=null, pmcid=null, year=2023, volume=38, issue=1, pageStart=94, pageEnd=102, url=null, language=null, rfNumber=20, rfOrder=19, authorNames=KANEMITSU T, UEDO N, ONO T, journalName=J Gastroenterol Hepatol, refType=null, unstructuredReference=KANEMITSU T,UEDO N,ONO T,et al. Magnifying endoscopy with narrow-band imaging for diagnosis of subtype of gastric intestinal metaplasia[J]. J Gastroenterol Hepatol,2023,38(1):94-102., articleTitle=Magnifying endoscopy with narrow-band imaging for diagnosis of subtype of gastric intestinal metaplasia, refAbstract=null), Reference(id=1322934782061052892, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1186/s12943-024-02016-9, pmid=null, pmcid=null, year=2024, volume=23, issue=1, pageStart=124, pageEnd=null, url=null, language=null, rfNumber=21, rfOrder=20, authorNames=WEI H F, LI W C, ZENG L L, journalName=Mol Cancer, refType=null, unstructuredReference=WEI H F,LI W C,ZENG L L,et al. OLFM4 promotes the progression of intestinal metaplasia through activation of the MYH9/GSK3β/β-catenin pathway[J]. Mol Cancer,2024,23(1):124., articleTitle=OLFM4 promotes the progression of intestinal metaplasia through activation of the MYH9/GSK3β/β-catenin pathway, refAbstract=null), Reference(id=1322934782128161757, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1158/2159-8290.CD-21-1059, pmid=null, pmcid=null, year=2022, volume=12, issue=1, pageStart=31, pageEnd=46, url=null, language=null, rfNumber=22, rfOrder=21, authorNames=HANAHAN D, journalName=Cancer Discov, refType=null, unstructuredReference=HANAHAN D. Hallmarks of cancer:new dimensions[J]. Cancer Discov,2022,12(1):31-46., articleTitle=Hallmarks of cancer:new dimensions, refAbstract=null), Reference(id=1322934782195270622, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=null, pmid=null, pmcid=null, year=1993, volume=53, issue=7, pageStart=1690, pageEnd=1695, url=null, language=null, rfNumber=23, rfOrder=22, authorNames=MAYER B, JOHNSON J P, LEITL F, journalName=Cancer Res, refType=null, unstructuredReference=MAYER B,JOHNSON J P,LEITL F,et al. E-cadherin expression in primary and metastatic gastric cancer:down-regulation correlates with cellular dedifferentiation and glandular disintegration[J]. Cancer Res,1993,53(7):1690-1695., articleTitle=E-cadherin expression in primary and metastatic gastric cancer:down-regulation correlates with cellular dedifferentiation and glandular disintegration, refAbstract=null), Reference(id=1322934782270768095, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, doi=10.1002/path.5434, pmid=null, pmcid=null, year=2020, volume=251, issue=2, pageStart=135, pageEnd=146, url=null, language=null, rfNumber=24, rfOrder=23, authorNames=ZHANG Y J, WU X, ZHANG C L, journalName=J Pathol, refType=null, unstructuredReference=ZHANG Y J,WU X,ZHANG C L,et al. Dissecting expression profiles of gastric precancerous lesions and early gastric cancer to explore crucial molecules in intestinal-type gastric cancer tumorigenesis[J]. J Pathol,2020,251(2):135-146., articleTitle=Dissecting expression profiles of gastric precancerous lesions and early gastric cancer to explore crucial molecules in intestinal-type gastric cancer tumorigenesis, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322934771441075057, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, xref=1, ext=[AuthorCompanyExt(id=1322934771449463666, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, companyId=1322934771441075057, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Department of Gastroenterology,Chongqing Key Laboratory of Precise Prevention and Treatment of Digestive Malignancies, Chongqing,China), AuthorCompanyExt(id=1322934771457852275, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, companyId=1322934771441075057, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1陆军特色医学中心(第三军医大学大坪医院):消化内科,消化系统肿瘤精准防治重庆市重点实验室,重庆)]), AuthorCompany(id=1322934771537544052, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, xref=2, ext=[AuthorCompanyExt(id=1322934771545932661, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, companyId=1322934771537544052, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Department of Pathology,Army Medical Center of PLA/Daping Hospital of Third Military Medical University,Chongqing, Chongqing,China), AuthorCompanyExt(id=1322934771554321270, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, companyId=1322934771537544052, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2陆军特色医学中心(第三军医大学大坪医院):病理科,重庆)]), AuthorCompany(id=1322934771638207351, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, xref=3, ext=[AuthorCompanyExt(id=1322934771646595960, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, companyId=1322934771638207351, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3First Clinical College of Chongqing Medical University, Chongqing,China), AuthorCompanyExt(id=1322934771654984569, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, companyId=1322934771638207351, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3重庆医科大学第一临床学院,重庆)])], figs=[ArticleFig(id=1322934776973362105, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, language=EN, label=null, caption=null, figureFileSmall=S50dqsMfMpLvnhId0fSa3A==, figureFileBig=QHZ74AgKkz98QFP6gjL64Q==, tableContent=null), ArticleFig(id=1322934777057248186, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, language=CN, label=图1, caption=LCPL征象的典型内镜下表现(A、B),HID-AB(C)和HE(D)染色结果

黄色虚线内区域:LCPL征象;黄色箭头:阳性细胞

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指标慢性炎症组
(n=106)
低危肠化组
(n=104)
高危肠化组
(n=107)
高-中分化肠型胃癌组
(n=15)
低分化肠型胃癌组
(n=18)
P
性别0.687
女性46(43.40)43(41.35)39(36.45)4(26.67)7(38.89)
男性60(56.60)61(58.65)68(63.55)11(73.33)11(61.11)
年龄/岁56.1±10.257.0±10.458.8±9.062.1±7.456.6±12.20.063
内镜检查史0.424
无19(17.92)9(8.65)6(5.61)2(13.33)1(5.56)
有87(82.08)95(91.35)101(94.39)13(86.67)17(94.44)
既往内镜检查目的0.128
随访50(47.17)70(67.31)70(65.42)9(60.00)8(44.44)
内镜下手术后复诊15(14.15)8(7.69)12(11.21)1(6.67)5(27.78)
消化系统症状查因36(33.96)23(22.12)23(21.50)4(26.67)4(22.22)
体检5(4.72)3(2.88)2(1.87)1(6.67)1(5.56)
), ArticleFig(id=1322934777829000128, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, language=CN, label=表1, caption=

各组临床基线特征比较[例(%),x¯±s]

, figureFileSmall=null, figureFileBig=null, tableContent=
指标慢性炎症组
(n=106)
低危肠化组
(n=104)
高危肠化组
(n=107)
高-中分化肠型胃癌组
(n=15)
低分化肠型胃癌组
(n=18)
P
性别0.687
女性46(43.40)43(41.35)39(36.45)4(26.67)7(38.89)
男性60(56.60)61(58.65)68(63.55)11(73.33)11(61.11)
年龄/岁56.1±10.257.0±10.458.8±9.062.1±7.456.6±12.20.063
内镜检查史0.424
无19(17.92)9(8.65)6(5.61)2(13.33)1(5.56)
有87(82.08)95(91.35)101(94.39)13(86.67)17(94.44)
既往内镜检查目的0.128
随访50(47.17)70(67.31)70(65.42)9(60.00)8(44.44)
内镜下手术后复诊15(14.15)8(7.69)12(11.21)1(6.67)5(27.78)
消化系统症状查因36(33.96)23(22.12)23(21.50)4(26.67)4(22.22)
体检5(4.72)3(2.88)2(1.87)1(6.67)1(5.56)
), ArticleFig(id=1322934777904497601, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
指标HID-AB阳性
(n=126)
HID-AB阴性
(n=224)
单因素分析多因素分析
OR(95%CI)POR(95%CI)P
年龄/岁
<6062(49.21)139(62.05)11
≥6064(50.79)85(37.95)1.584(1.019~2.463)0.0412.172(1.159~4.070)0.016
性别
女性46(36.51)93(41.52)1
男性80(63.49)131(58.48)1.235(0.788~1.936)0.358
病变部位
贲门、胃体19(15.08)60(26.79)11
胃角46(36.51)31(13.84)0.690(0.380~1.256)0.2251.460(0.648~3.287)0.361
胃窦61(48.41)133(59.37)3.235(1.872~5.591)< 0.0012.913(1.380~6.150)0.005
萎缩性胃炎
否4(3.17)73(32.59)11
是122(96.83)151(67.41)14.745(5.241~41.483)< 0.0016.918(1.864~18.789)0.003
Hp感染
否81(64.29)149(66.52)1
是45(35.71)75(33.48)1.104(0.698~1.745)0.673
消化性溃疡
否119(94.45)203(90.63)1
是7(5.55)21(9.37)0.569(0.235~1.378)0.211
LCPL
否38(30.16)210(93.75)11
是88(69.84)14(6.25)34.737(17.929~67.302)< 0.00130.286(13.528~67.804)< 0.001
LBC
否30(23.81)145(64.73)11
是96(76.19)79(35.27)5.873(3.587~9.617)< 0.0010.867(0.416~1.807)0.703
), ArticleFig(id=1322934777979995074, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, language=CN, label=表2, caption=

高危肠化临床特征及镜下表现的单因素、多因素Logistic回归分析[例(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
指标HID-AB阳性
(n=126)
HID-AB阴性
(n=224)
单因素分析多因素分析
OR(95%CI)POR(95%CI)P
年龄/岁
<6062(49.21)139(62.05)11
≥6064(50.79)85(37.95)1.584(1.019~2.463)0.0412.172(1.159~4.070)0.016
性别
女性46(36.51)93(41.52)1
男性80(63.49)131(58.48)1.235(0.788~1.936)0.358
病变部位
贲门、胃体19(15.08)60(26.79)11
胃角46(36.51)31(13.84)0.690(0.380~1.256)0.2251.460(0.648~3.287)0.361
胃窦61(48.41)133(59.37)3.235(1.872~5.591)< 0.0012.913(1.380~6.150)0.005
萎缩性胃炎
否4(3.17)73(32.59)11
是122(96.83)151(67.41)14.745(5.241~41.483)< 0.0016.918(1.864~18.789)0.003
Hp感染
否81(64.29)149(66.52)1
是45(35.71)75(33.48)1.104(0.698~1.745)0.673
消化性溃疡
否119(94.45)203(90.63)1
是7(5.55)21(9.37)0.569(0.235~1.378)0.211
LCPL
否38(30.16)210(93.75)11
是88(69.84)14(6.25)34.737(17.929~67.302)< 0.00130.286(13.528~67.804)< 0.001
LBC
否30(23.81)145(64.73)11
是96(76.19)79(35.27)5.873(3.587~9.617)< 0.0010.867(0.416~1.807)0.703
), ArticleFig(id=1322934778051298243, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
指标LCPL阳性
(n=102)
LCPL阴性
(n=248)
单因素分析多因素分析
OR(95%CI)POR(95%CI)P
年龄/岁
<6057(55.88)146(58.87)1
≥6045(44.12)102(41.13)1.130(0.709~1.800)0.607
性别
女性70(68.63)141(56.85)11
男性32(31.37)107(43.15)1.660(1.019~2.704)0.0421.614(0.754~3.455)0.218
病变部位
贲门、胃体12(11.76)67(27.02)11
胃角36(35.30)41(16.53)4.902(2.292~10.485)<0.0012.360(0.732~7.613)0.151
胃窦54(52.94)140(56.45)2.154(1.080~4.294)0.0292.257(0.756~6.744)0.145
萎缩性胃炎
否2(1.96)75(30.24)11
是100(98.04)173(69.76)21.676(5.210~90.188)<0.0012.530(0.425~15.065)0.308
Hp感染
否71(69.61)159(64.11)1
是31(30.39)89(35.89)0.780(0.475~1.280)0.326
消化性溃疡
否99(97.06)223(89.82)11
是3(2.94)25(10.08)0.270(0.080~0.916)0.0361.085(0.208~5.652)0.923
LCPL判别速度/s
≥3(慢)6(5.88)82(33.06)11
<3(快)96(94.12)166(66.94)7.904(3.324~18.793)<0.0014.536(1.372~14.997)0.013
病变类型
慢性炎症5(4.90)101(40.73)11
低危肠化11(10.79)93(37.50)2.389(0.800~7.135)0.1190.445(0.125~1.582)0.210
高危肠化81(79.41)26(10.48)62.931(23.133~171.195)<0.00113.191(3.999~43.521)<0.001
胃癌5(4.90)28(11.29)3.607(0.975~13.347)0.0554.082(0.843~19.777)0.081
), ArticleFig(id=1322934778122601412, tenantId=1146029695717560320, journalId=1319373162502258839, articleId=1322934768572171110, language=CN, label=表3, caption=

LCPL临床特征的单因素、多因素Logistic回归分析[例(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
指标LCPL阳性
(n=102)
LCPL阴性
(n=248)
单因素分析多因素分析
OR(95%CI)POR(95%CI)P
年龄/岁
<6057(55.88)146(58.87)1
≥6045(44.12)102(41.13)1.130(0.709~1.800)0.607
性别
女性70(68.63)141(56.85)11
男性32(31.37)107(43.15)1.660(1.019~2.704)0.0421.614(0.754~3.455)0.218
病变部位
贲门、胃体12(11.76)67(27.02)11
胃角36(35.30)41(16.53)4.902(2.292~10.485)<0.0012.360(0.732~7.613)0.151
胃窦54(52.94)140(56.45)2.154(1.080~4.294)0.0292.257(0.756~6.744)0.145
萎缩性胃炎
否2(1.96)75(30.24)11
是100(98.04)173(69.76)21.676(5.210~90.188)<0.0012.530(0.425~15.065)0.308
Hp感染
否71(69.61)159(64.11)1
是31(30.39)89(35.89)0.780(0.475~1.280)0.326
消化性溃疡
否99(97.06)223(89.82)11
是3(2.94)25(10.08)0.270(0.080~0.916)0.0361.085(0.208~5.652)0.923
LCPL判别速度/s
≥3(慢)6(5.88)82(33.06)11
<3(快)96(94.12)166(66.94)7.904(3.324~18.793)<0.0014.536(1.372~14.997)0.013
病变类型
慢性炎症5(4.90)101(40.73)11
低危肠化11(10.79)93(37.50)2.389(0.800~7.135)0.1190.445(0.125~1.582)0.210
高危肠化81(79.41)26(10.48)62.931(23.133~171.195)<0.00113.191(3.999~43.521)<0.001
胃癌5(4.90)28(11.29)3.607(0.975~13.347)0.0554.082(0.843~19.777)0.081
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内镜下LCPL征象对胃黏膜高危肠上皮化生的诊断价值
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郑喜鹏 1 , 潘惠琳 1 , 吴林育 1 , 侯永英 2 , 刘琴 1 , 马强 2 , 秦修远 3 , 刘凯军 1 , 王斌 1 , 陈东风 1 , 王涛 1
陆军军医大学学报 | 专题报道 2025,47(5): 407-416
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陆军军医大学学报 |专题报道 2025 , 47 (5) : 407 -416
内镜下LCPL征象对胃黏膜高危肠上皮化生的诊断价值
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郑喜鹏1, 潘惠琳1, 吴林育1, 侯永英2, 刘琴1, 马强2, 秦修远3, 刘凯军1, 王斌1, 陈东风1, 王涛1
作者信息
  • 1陆军特色医学中心(第三军医大学大坪医院):消化内科,消化系统肿瘤精准防治重庆市重点实验室,重庆
  • 2陆军特色医学中心(第三军医大学大坪医院):病理科,重庆
  • 3重庆医科大学第一临床学院,重庆
通讯作者:
王 涛,E-mail:
WANG Tao,E-mail:
Diagnostic value of endoscopic LCPL sign for high-risk intestinal metaplasia in gastric mucosa
Xipeng ZHENG1, Huilin PAN1, Linyu WU1, Yongying HOU2, Qin LIU1, Qiang MA2, Xiuyuan QIN3, Kaijun LIU1, Bin WANG1, Dongfeng CHEN1, Tao WANG1
Affiliations
  • 1Department of Gastroenterology,Chongqing Key Laboratory of Precise Prevention and Treatment of Digestive Malignancies, Chongqing,China
  • 2Department of Pathology,Army Medical Center of PLA/Daping Hospital of Third Military Medical University,Chongqing, Chongqing,China
  • 3First Clinical College of Chongqing Medical University, Chongqing,China
出版时间: 2025-03-15 doi: 10.16016/j.2097-0927.202409149
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目的

探讨内镜下亮蓝嵴(light blue crest,LBC)包绕的乳头状区域(LBC capsuling papillary lesion,LCPL)征象在高危胃黏膜肠上皮化生(intestinal metaplasia,IM,简称“肠化”)中的诊断价值。

方法

选取2021年1月至2023年6月在陆军特色医学中心消化内科接受内镜检查及活检的314例患者(共352块活检样本)。采用HE染色及高铁二胺-阿尔新蓝(high iron diamine-alcian blue,HID-AB)染色(诊断高危肠化的金标准)检查样本的组织学类型及肠化类型,并据此将样本分为慢性炎症组、低危肠化组、高危肠化组、高-中分化肠型胃癌组、低分化肠型胃癌组。结合活检部位内镜下图像,统计分析LCPL在各组中的阳性率;采用Logistic回归分析LCPL征象与高危肠化的关系,以及与LCPL相关的临床病理特征;采用灵敏度、特异度、约登指数、受试者工作曲线下面积等指标,评价LCPL对高危肠化的诊断效能。

结果

LCPL征象在高危肠化组的阳性率达75.70%,显著高于其他各组(P均<0.001);Logistic回归分析显示LCPL与高危肠化密切相关(OR=30.286,95%CI:13.528~67.804,P<0.001)。LCPL征象诊断高危肠化的灵敏度为69.84%、特异度为93.75%、约登指数为0.636、曲线下面积为0.818(95%CI:0.773~0.857);除灵敏度指标外,上述各诊断效能参数均显著优于诊断肠化与否的传统内镜下征象LBC(P均<0.001)。并且,LCPL征象的判别不易受到患者年龄(OR=1.130,95%CI:0.709~1.800,P=0.607)、病变部位(胃角:OR=2.360,95%CI:0.732~7.613,P=0.151;胃窦:OR=2.257,95%CI:0.756~6.744,P=0.145)、是否合并消化性溃疡(OR=1.085,95%CI:0.208~5.652,P=0.923)等因素的影响;94.12%的阳性、66.94%的阴性LCPL征象可在3 s内被快速识别(OR=4.536,95%CI:1.372~14.997,P=0.013)。

结论

内镜下LCPL征象在诊断胃黏膜高危肠化中有较好效能,具有潜在临床应用价值。

肠上皮化生  /  胃癌  /  内镜  /  诊断
Objective‍

To investigate the diagnostic value of endoscopic sign of light blue crest (LBC) capsuling papillary lesion (LCPL) for high-risk intestinal metaplasia (IM).

Methods‍

A total of 314 patients (352 biopsy specimens) who underwent endoscopic examination and biopsy in Department of Gastroenterology of Army Medical Center of PLA from January 2021 to June 2023 were recruited, and HE and HID-AB staining (the golden standard of high-risk IM) were apllied to detect the histological types and IM types. The samples were subsequently divided into chronic inflammation group, low-risk IM group, high-risk IM group, well-differentiated intestinal-type gastric cancer group, and poorly-differentiated intestinal-type gastric cancer group. The positive rate of LCPL in each group and its diagnostic efficacy were analyzed based on endoscopic images of the biopsy sites. Logistic regression analysis was used to investigate the relationship between LCPL sign and high-risk IM, as well as the clinical and pathological features associated with LCPL sign. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficacy of LCPL for high-risk IM, using indicators such as sensitivity, specificity, Youden index and area under the curve (AUC).

Results‍

The positive rate of the LCPL sign in high-risk IM group was 75.70%, significantly higher than that of the other groups (all P<0.001). Logistic regression analysis showed that LCPL sign was significantly correlated with high-risk IM (OR=30.286, 95%CI: 13.528~67.804, P<0.001). When the sign was employed in diagnosing high-risk IM, the sensitivity was 69.84%, the specificity was 93.75%, the Youden’s index was 0.636, and the AUC value was 0.818 (95%CI: 0.773~0.857). Besides sensitivity, all above parameters of LCPL sign showed significantly better diagnostic efficacy than those of traditional LBC sign, which is used as a sign for diagnosing IM (P<0.001). Moreover, recognition of LCPL sign was not easily affected by age (OR=1.130, 95%CI: 0.709~1.800, P=0.607), lesion site (Angular incisure: OR=2.360, 95%CI: 0.732~7.613, P=0.151; Autrum: OR=2.257, 95%CI: 0.756~6.744, P=0.145), and presence of peptic ulcers (OR=1.085, 95%CI: 0.208~5.652, P=0.923). Significantly, 94.12% of positive and 66.94% of negative LCPL signs could be rapidly recognized within 3 s (OR=4.536, 95%CI: 1.372~14.997, P=0.013).

Conclusion‍

LCPL sign shows high efficacy and potential clinical application value for high-risk IM in gastric mucosa of endoscopic diagnosis.

high-risk intestinal metaplasia  /  gastric cancer  /  endoscopy  /  diagnosis
郑喜鹏, 潘惠琳, 吴林育, 侯永英, 刘琴, 马强, 秦修远, 刘凯军, 王斌, 陈东风, 王涛. 内镜下LCPL征象对胃黏膜高危肠上皮化生的诊断价值. 陆军军医大学学报, 2025 , 47 (5) : 407 -416 . DOI: 10.16016/j.2097-0927.202409149
Xipeng ZHENG, Huilin PAN, Linyu WU, Yongying HOU, Qin LIU, Qiang MA, Xiuyuan QIN, Kaijun LIU, Bin WANG, Dongfeng CHEN, Tao WANG. Diagnostic value of endoscopic LCPL sign for high-risk intestinal metaplasia in gastric mucosa[J]. Journal of Army Medical University, 2025 , 47 (5) : 407 -416 . DOI: 10.16016/j.2097-0927.202409149
胃癌是我国高发的恶性肿瘤,年患病人数及死亡人数分别位于所有恶性肿瘤的第五位及第三位[1],严重威胁人民健康。我国超过80%胃癌患者确诊时已处于进展期,即使接受外科手术等综合治疗,5年生存率也仅有约30%[2],但早期胃癌治疗后5年生存率高达95%[3]。因此,准确识别胃癌发生前的高危病变,科学制定随访策略,对提高胃癌早诊早治率、改善总体临床疗效和患者预后均至关重要。
在大多数胃癌发生过程中,胃黏膜上皮细胞经历慢性非萎缩性胃炎、慢性萎缩性胃炎、肠上皮化生(intestinal metaplasia,IM,简称肠化)的多阶段癌变过程[4]。其中,肠化是最临近胃癌发生且难以逆转的癌前病变[5-6]。根据分泌的黏蛋白类型,肠化可分为完全小肠型(Ⅰ型肠化)、不完全小肠型(Ⅱ型肠化)、不完全大肠型(Ⅲ型肠化)。相较Ⅰ型与Ⅱ型肠化,Ⅲ型肠化可分泌硫酸化酸性黏蛋白,在高铁二胺-阿尔新蓝(high iron diamine-alcian blue,HID-AB)染色下呈褐色[7-8],从而得以判别。在病理形态上,Ⅲ型肠化表现为与Ⅰ型、Ⅱ型肠化显著不同的腺体结构扭曲、杯状及柱状细胞发育不良等特点[7];在发生时序上,Ⅲ型肠化被认为是前2型肠化进展的后续结果[8-9]。在向胃癌进展的风险上,Ⅲ型肠化(OR≈10)显著高于Ⅰ型(OR≈3)及Ⅱ型肠化(OR≈5)[10-13]。基于这3类特征,Ⅲ型肠化被称为高危肠化,需准确识别并密切随访。
消化内镜检查是临床诊断胃癌及癌前病变的首选方式。既往研究发现,肠化病变在窄带放大成像模式(magnifying endoscopy with narrow band imaging,ME-NBI)下可呈现亮蓝嵴(light blue crest,LBC)征象,这是目前内镜下诊断肠化的主要依据[14-15]。但LBC仅能提示病灶存在Ⅰ型肠化[14],而向癌症进展风险更高的Ⅲ型肠化(高危肠化)目前尚缺乏对应的用于诊断的内镜下征象。
胃黏膜腺体结构决定了内镜下病变形态的特征,而腺体结构的改变,则以细胞生物学的变化为基础。新近研究显示,肠化细胞来源于长期慢性炎症微环境驱动下的胃腺体颈部干细胞的转分化事件[8-9]。由于这样的克隆性形成规律,Ⅰ、Ⅱ、Ⅲ型肠化呈靶形分布:外层的Ⅰ型、Ⅱ型肠化呈LBC样改变;内层的Ⅲ型肠化由于腺体结构紊乱,可能呈乳头状改变[16]。基于这一规律,结合平时临床实践,LBC环形包绕的乳头状区域(LBC capsuling papillary lesion,LCPL)可能是Ⅲ型肠化(高危肠化)的潜在内镜下征象。
本研究拟采用HID-AB染色为病理金标准[7-8],探讨LCPL在内镜下实时判断高危肠化的诊断价值,以期为肠化患者的个性化随访方案制定、胃癌早诊早治疗提供新的思路及依据。
本研究共纳入2021年1月至2023年6月间在陆军特色医学中心消化内科内镜中心接受ME-NBI内镜检查及活检术的314例患者(共352块活检样本)。352块活检样本包括:350块胃黏膜活检样本;1块正常结肠样本和1块正常小肠样本(分别用于HID-AB阳性及阴性对照)。本研究已经陆军特色医学中心伦理委员会审批通过[医研伦审(2024)第54号]。
纳入标准:①年龄18~80岁;②患慢性萎缩性胃炎或肠化行内镜随访者;③接受早期胃癌内镜筛查者;④接受早癌内镜治疗后但仍有萎缩、肠化需内镜下随访者;⑤上述患者需在内镜检查过程中留有活检标本及活检部位清晰放大图像。排除标准:①幽门螺杆菌(Helicobacter pylori,Hp)感染活动期/黏膜广泛充血者;②急性胃黏膜病变患者;③正在接受抗Hp治疗或因其他原因正在服用质子泵抑制剂、H2受体拮抗剂等抑酸药者;④正在服用抗凝药或非甾体抗炎药,有出血风险不适合活检者;⑤患有恶性肿瘤,正在进行抗肿瘤治疗者;⑥妊娠期患者。
采用PASS 15.0软件中的“单组设计的灵敏度与特异性的置信区间”方法计算样本量。前期预实验获知LCPL诊断高危肠化的灵敏度为0.79,特异度为0.90,活检样本中高危肠化的患病率为0.35;在α=0.05,容许误差δ为8%、置信度为0.95的条件下,计算出研究至少需要纳入样本286例,其中高危肠化100例。
根据纳入研究样本的活检病理诊断(基于HE染色)结果,将样本分为慢性炎症组(n=106)、肠化组(n=211)、高-中分化肠型胃癌组(n=15)、低分化肠型胃癌组(n=18)。而后根据活检样本石蜡包埋组织的HID-AB染色(方法见下述)结果,进一步将肠化组分为低危肠化组(即Ⅰ型与Ⅱ型肠化,n=104)及高危肠化组(即Ⅲ型肠化,n=107)。
本研究纳入样本的临床资料包括:①基线临床信息:年龄、性别、内镜检查史、接受内镜检查的目的等;②内镜检查结果:通过拷取患者在接受内镜检查时所采集的全部图片,结合诊断描述,获取胃黏膜是否萎缩、Hp感染情况、是否存在溃疡、活检部位及其内镜下特征(如是否存在LCPL、LBC)等信息;③病理检查结果:内镜下活检组织的病理描述及报告、HE染色、HID-AB染色结果等。
检查使用的内窥镜系统为CV-290/CV-260(日本Olympus公司),使用内窥镜为GIF-H290Z/GIF-H260Z(日本Olympus公司),内窥镜结构增强功能在白光模式(white light imaging,WLI)模式为B-6,在NBI模式为B-8。检查前安装黑色软帽(日本Olympus公司)以便进行放大观察。检查前流程按常规胃镜检查进行。先应用WLI模式进行常规检查并采集图片,在WLI模式发现病灶的基础上,切换至NBI模式,并结合放大功能对病灶进行观察并采集图片,最后对病灶进行活检。检查结束后,将活检组织用10%福尔马林溶液固定后送至病理科进行石蜡包埋、切片、染色、诊断。
对3名有经验(内镜工作年限>5年)的内镜医生进行培训,使其明确并统一LCPL及LBC特征标准。LBC的判读标准同既往报道一致[14-15];LCPL征象的判读则严格按照“亮蓝嵴环形包绕的乳头状区域”予以判断。对于不能同时满足“亮蓝嵴环形包绕”、“乳头状区域”这2个关键词的病变部位,则判定为LCPL征象阴性。而后,这3名内镜医生独立对纳入研究样本的活检部位内镜图片进行分析和判读,并在特定电子表格中记录,表格一经登记不可随意修改。对于LCPL的判读时间,取3人判读时间的平均值:若判断有无LCPL所耗时间均值≤3 s,则认为该图片的LCPL征象识别速度快(易于识别),否则认为不易识别。
HID-AB染色阳性是诊断Ⅲ型肠化的金标准[7-8]。该染色利用我院病理科所存内镜下图像对应活检部位蜡块的切片,在消化病学实验室利用HID-AB试剂盒(中国Kehbio公司,货号BMF226-01)进行,方法如下:首先将层厚为4 μm的切片脱蜡至水,而后于配置好的HID溶液中浸染20 h,冲洗5 min;再利用AB溶液浸染15 min,而后稍冲洗并在核固红染色液中复染10 min;最后脱蜡透明、封片观察。HID-AB染色结果判读:因带有羧基的唾液酸性黏蛋白可与阿利新蓝作用,使Ⅰ型与Ⅱ型肠化(低危肠化)在HID-AB染色下呈蓝色;而Ⅲ型肠化(高危肠化)的柱状细胞及小凹内黏液含有的硫酸化酸性黏蛋白可与高铁二胺反应形成棕紫色或棕黑色复合物,可以此判别。
符合正态分布的计量资料以x¯±s表示,符合正态分布且方差齐性样本采用独立样本t检验;非正态分布或方差不齐样本采用秩和检验。计数资料以例(%)表示,根据频数分布选择Pearson χ2检验(理论频数≥5且单元格频数≥1)、连续性校正χ2检验(2≤理论频数<5)或Fisher确切概率法(理论频数<2或样本量<40)。数据采用SPSS 25.0软件进行分析,通过绘制受试者工作特征(receiver operating characteristic,ROC)曲线,计算曲线下面积(area under curve,AUC)、灵敏度、特异度及约登指数等指标,对LCPL及LBC的诊断效能进行评估。危险因素筛选通过单因素(P<0.05纳入)及多因素Logistic回归分析完成,结果以OR(95%CI)表示。检验均为双侧,以P<0.05为差异有统计学意义。
在慢性炎症组(n=106)、低危肠化组(n=104)、高危肠化组(n=107)、高-中分化肠型胃癌组(n=15)、低分化肠型胃癌组(n=18)样本之间,来源患者的性别、年龄、内镜检查史、接受内镜检查目的的差异均无统计学意义(表1)。提示这些数据的基线资料水平一致,适用于进行后续组间分析。
由于Ⅰ、Ⅱ、Ⅲ型肠化呈递进关系,故Ⅲ型肠化周边可能包绕由Ⅰ、Ⅱ型肠化上皮构成的LBC阳性改变,中央部分则由于Ⅲ型肠化细胞的排列相对扭曲,可能呈乳头状改变。基于这一规律,结合平时临床实践,我们认为内镜下LCPL征象可能是Ⅲ型肠化(高危肠化)的潜在内镜下征象。
使用内镜在WLI模式下观察,可见LCPL呈片状发红,与周围胃黏膜界限明显;抵近观察可见被发白腺体环形包绕的、呈乳头状改变的中央腺体(图1A)。在ME-NBI模式下观察时,可见病变中央部分的乳头状腺体形态稍不规则且呈LBC阴性,被LBC阳性腺体呈环状包绕(图1B)。对该部位活检并进行HID-AB染色后,可见大量呈棕紫色的柱状细胞及杯状细胞(图1C);HE染色可见腺管结构扭曲,杯状细胞大小不一,柱状细胞发育欠佳(图1D)。这些结果初步提示,内镜下呈LCPL征象的区域符合Ⅲ型肠化在病理学上的定义,可能提示高危肠化。
为探索内镜下LCPL征象对高危肠化是否具有提示作用,本研究采集了慢性炎症组、低危肠化组、高危肠化组、高-中分化肠型胃癌组、低分化肠型胃癌组病变部位,以及正常小肠(HID-AB染色的阴性对照)、正常结肠(HID-AB染色的阳性对照)的典型内镜下WLI、ME-NBI模式下的形态图片,结合HE及HID-AB染色结果,进行横向对比。结果显示,仅高危肠化组织具有LCPL征象和与之对应的HID-AB染色阳性(图2)。
随后统计LCPL征象在各组中的阳性率,以进行横向比较。LCPL在慢性炎症组、低危肠化组、高危肠化组、高-中分化肠型胃癌组、低分化肠型胃癌组中的阳性样本数量及阳性率分别为5(4.71%)、11(10.58%)、81(75.70%)、3(20.00%)、2(11.11%);且高危肠化组的阳性率显著高于其他各组,差异具有统计学意义(P<0.001)。
为进一步研究内镜下LCPL征象与高危肠化的关系,以高危肠化的病理诊断结果作为二分类因变量进行Logistic回归。单因素分析与随后的多因素分析结果显示,年龄≥60岁(OR=2.172,95%CI:1.159~4.070,P=0.016)、病变位于胃窦(OR=2.913,95%CI:1.380~6.150,P=0.05)、存在萎缩性胃炎(OR=6.918,95%CI:1.864~18.789,P=0.003)等因素均是诊断高危肠化的正向因素,与来自于大规模流行病学调查的肠化既往认识相符(表2)。而既往用于诊断Ⅰ型(低危)肠化的内镜下征象——LBC,并不能独立成为诊断高危肠化的正向因素(OR=0.867,95%CI:0.416~1.807,P=0.703);而LCPL征象处病变,在单因素(OR=34.737,95%CI:17.929~67.302,P<0.001)及多因素(OR=30.286,95%CI:13.528~67.804,P<0.001)分析中均更易形成高危肠化(表2),从而进一步提示,LCPL征象与高危肠化具有密切联系。
基于内镜下LCPL征象与高危肠化的关联性,结合内镜下的LCPL征象与HID-AB染色结果的相符程度,进而探讨LCPL是否能够作为诊断高危肠化的指标。统计分析结果显示:LCPL诊断高危肠化的灵敏度为69.84%,特异度为93.75%,约登指数(灵敏度+特异度-1,用于评价发现真正的患者与非患者的总能力)为0.636。通过绘制ROC曲线,计算AUC为0.818(95%CI:0.773~0.857)。
同时,评估LBC在诊断高危肠化中的价值:其灵敏度为76.19%,特异度为64.74%,约登指数为0.409,AUC为0.705(95%CI:0.654~0.752)。将这两种征象进行对比,可见LCPL在特异度、约登指数、AUC等诊断效能指标上均优于LBC,差异具有统计学意义(P<0.001,图3)。
在分析可能影响内镜下LCPL征象识别的临床病理因素,以进一步确定其应用范围时,不仅在单因素(OR=62.931,P<0.001)及多因素(OR=13.191,P<0.001)分析中发现,高危肠化病变更易出现LCPL征象。而且在多因素分析中,LCPL征象判别结果与患者年龄、性别、病变部位、是否存在萎缩性胃炎、有无Hp感染、存在消化性溃疡与否等因素均无显著关联(P均>0.05)。提示LCPL可能并不受到上述内镜检查患者特征的影响,具有较为广泛的临床应用场景(表3)。此外,94.12%的阳性、66.94%的阴性LCPL征象可在3 s内被快速判别,有助于阳性病变的发现(单因素OR=7.904,95%CI:3.324~18.793,P<0.001; 多因素OR=4.536,95%CI:1.372~14.997,P=0.013)。该结果提示LCPL征象在临床应用中较易辨认,具有良好的实时诊断价值。
高危肠化是胃癌发生前的“最后一步”和关键环节,而内镜检查是胃癌筛查及癌前病变诊断中最可靠的方式之一。因此,内镜检查中能够实时、准确诊断高危肠化的征象,有助于提高胃癌早诊早治及精准预防水平。
UEDO等[14]在2006年首先提出内镜下诊断肠化的经典征象LBC,并在临床推广沿用至今。然而,LBC征象仅能反映Ⅰ型(低危)肠化区域,并不能真正判断遴选出高危癌变患者,限制了其临床意义。KANEMITSU等[17]于2017年提出,黏膜表面的白色不透明物(white opaque substance,WOS)可能是高危肠化的内镜下征象,但该征象易与胃黏膜表面附着的黏液相混淆,需要仔细判别。更重要的是,WOS同时也提示高分化早期胃癌[18-19],导致阳性病例中掺杂大量非高危肠化病变。事实上,目前更多的临床内镜医师仅将WOS视为诊断早癌的辅助征象。该学者在2023年又提出,肠化腺体表面微结构可能提示不完全型肠化[20],因不完全型肠化同时包含了Ⅱ型及Ⅲ型肠化,故其将胃癌发生风险迥异的两类肠化进行混杂诊断,仍不能达到准确诊断高危肠化的目的。这可能是该项研究在多因素Logistic回归分析中发现肠化腺体表面微结构与不完全型肠化之间的关联性并无统计学意义的重要原因[20]。综上,目前仍无针对性诊断Ⅲ型肠化的内镜下征象。
本研究尝试从Ⅰ、Ⅱ、Ⅲ型肠化克隆性演进中的细胞生物学特征出发,将胃黏膜细胞行为与其内镜下表现统一而提出LCPL征象,是探索高危肠化内镜下征象的全新角度。本研究发现,LCPL征象在高危肠化中显著富集,而在高-中分化肠型胃癌组中阳性率较低。肿瘤发生过程中的上皮细胞去分化过程是造成这种现象的可能原因:肠上皮化生表达高水平的肠道细胞分化标志物如CD10[14]、MUC2[21]等,增殖并不显著,是一种分化较为完全的病理状态,而细胞分化特征丢失(去分化)是包括胃癌在内的众多肿瘤在发生过程中的共性特征[22-24]。即使是高分化肠型胃癌,在内镜表现、病理形态、细胞行为、分子谱征等方面也与肠化组织具有质的差异,从而使其带有偏向幼稚细胞的组织结构与增殖模式。本研究还发现,低分化肠型胃癌组的LCPL阳性率较高-中分化肠型胃癌组进一步降低,也从侧面佐证了上述可能。这些数据不仅进一步显示了LCPL在诊断高危肠化中的特异性,也提示LCPL可能是一个由肠谱系分化细胞所维持的内镜下征象。
在诊断效能与准确性上,LCPL具有优于传统征象LBC的特异度及约登指数,体现了其良好的诊断效能。但本研究也发现LCPL诊断高危肠化的灵敏度略低于LBC,这可能是由于LBC征象能判断更大比例的肠化病变,其中包含了少量Ⅲ型肠化腺体所致,实质上也是肠化克隆进展不同步或其细胞异质性的体现。
除准确性外,适用场景/患者人群、易辨别程度也是评价内镜下诊断征象推广价值的重要指标。本研究亦发现,LCPL征象的判别不易受到患者年龄、病变部位、是否合并其他病变的影响。并且,LCPL征象易于在极短时间(<3 s)内被快速识别。因此,LCPL征象不仅适用于常规肠化病灶的实时诊断、恶性潜能预判,且在带有多发、广泛肠化病灶的胃癌高风险患者中也具有较好的临床应用场景:这类患者的内镜精查往往耗时较长,且难以选择进行活检的准确部位,而LCPL征象的判断有助于更快速地让内镜医生获知应仔细观察、活检并随访的病变部位。从本研究数据看,LCPL征象兼有适用人群的广泛性、判别的实时性,具有潜在的推广价值。但本研究是在单中心内进行的,后续需在更大队列规模、更多中心参与的前瞻性研究中进一步评估LCPL征象的临床应用价值,以更好地为高危肠化患者准确识别、制定个性化随访方案以及胃癌精准预防提供参考。

参考文献 引证文献
排序方式:
1
HAN B F,ZHENG R S,ZENG H M,et al. Cancer incidence and mortality in China,2022[J]. J Natl Cancer Cent,2024,4(1):47-53.
2
KATAI H,ISHIKAWA T,AKAZAWA K,et al. Five-year survival analysis of surgically resected gastric cancer cases in Japan:a retrospective analysis of more than 100 000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001-2007)[J]. Gastric Cancer,2018,21(1):144-154.
3
SUMIYAMA K. Past and current trends in endoscopic diagnosis for early stage gastric cancer in Japan[J]. Gastric Cancer,2017,20(Suppl 1):20-27.
4
CORREA P. Human gastric carcinogenesis:a multistep and multifactorial process—First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention[J]. Cancer Res,1992,52(24):6735-6740.
5
HIGA J T,HWANG J H. Gastric intestinal metaplasia:an irreversible risk factor for gastric cancer?[J]. Gastrointest Endosc,2016,84(4):625-627.
6
TAHARA T,TAHARA S,HORIGUCHI N,et al. Gastric mucosal microarchitectures associated with irreversibility with Helicobacter pylori eradication and downregulation of micro RNA (miR)-124a[J]. Cancer Invest,2019,37(9):417-426.
7
SHAH S C,GAWRON A J,MUSTAFA R A,et al. Histologic subtyping of gastric intestinal metaplasia:overview and considerations for clinical practice[J]. Gastroenterology,2020,158(3):745-750.
8
GOLDENRING J R,MILLS J C. Cellular plasticity,reprogramming,and regeneration:metaplasia in the stomach and beyond[J]. Gastroenterology,2022,162(2):415-430.
9
GIROUX V,RUSTGI A K. Metaplasia:tissue injury adaptation and a precursor to the dysplasia-cancer sequence[J]. Nat Rev Cancer,2017,17(10):594-604.
10
GUPTA S,LI D,SERAG H B EL,et al. AGA clinical practice guidelines on management of gastric intestinal metaplasia[J]. Gastroenterology,2020,158(3):693-702.
11
PIMENTEL-NUNES P,LIBÂNIO D,MARCOS-PINTO R,et al. Management of epithelial precancerous conditions and lesions in the stomach (MAPS Ⅱ):European Society of Gastrointestinal Endoscopy (ESGE),European Helicobacter and Microbiota Study Group (EHMSG),European Society of Pathology (ESP),and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019[J]. Endoscopy,2019,51(4):365-388.
12
PIAZUELO M B,BRAVO L E,MERA R M,et al. The Colombian chemoprevention trial:20-year follow-up of a cohort of patients with gastric precancerous lesions[J]. Gastroenterology,2021,160(4):1106-1117.e3.
13
GONZÁLEZ C A,SANZ-ANQUELA J M,GISBERT J P,et al. Utility of subtyping intestinal metaplasia as marker of gastric cancer risk. A review of the evidence[J]. Int J Cancer,2013,133(5):1023-1032.
14
UEDO N,ISHIHARA R,IISHI H,et al. A new method of diagnosing gastric intestinal metaplasia:narrow-band imaging with magnifying endoscopy[J]. Endoscopy,2006,38(8):819-824.
15
PIMENTEL-NUNES P,DINIS-RIBEIRO M,SOARES J B,et al. A multicenter validation of an endoscopic classification with narrow band imaging for gastric precancerous and cancerous lesions[J]. Endoscopy,2012,44(3):236-246.
16
KANZAKI H,UEDO N,ISHIHARA R,et al. Comprehensive investigation of areae gastricae pattern in gastric corpus using magnifying narrow band imaging endoscopy in patients with chronic atrophic fundic gastritis[J]. Helicobacter,2012,17(3):224-231.
17
KANEMITSU T,YAO K S,NAGAHAMA T,et al. Extending magnifying NBI diagnosis of intestinal metaplasia in the stomach:the white opaque substance marker[J]. Endoscopy,2017,49(6):529-535.
18
YAO K S,IWASHITA A,TANABE H,et al. White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow-band imaging:a new optical sign for differentiating between adenoma and carcinoma[J]. Gastrointest Endosc,2008,68(3):574-580.
19
HAYEE B,INOUE H,SATO H,et al. Magnification narrow-band imaging for the diagnosis of early gastric cancer:a review of the Japanese literature for the western endoscopist[J]. Gastrointest Endosc,2013,78(3):452-461.
20
KANEMITSU T,UEDO N,ONO T,et al. Magnifying endoscopy with narrow-band imaging for diagnosis of subtype of gastric intestinal metaplasia[J]. J Gastroenterol Hepatol,2023,38(1):94-102.
21
WEI H F,LI W C,ZENG L L,et al. OLFM4 promotes the progression of intestinal metaplasia through activation of the MYH9/GSK3β/β-catenin pathway[J]. Mol Cancer,2024,23(1):124.
22
HANAHAN D. Hallmarks of cancer:new dimensions[J]. Cancer Discov,2022,12(1):31-46.
23
MAYER B,JOHNSON J P,LEITL F,et al. E-cadherin expression in primary and metastatic gastric cancer:down-regulation correlates with cellular dedifferentiation and glandular disintegration[J]. Cancer Res,1993,53(7):1690-1695.
24
ZHANG Y J,WU X,ZHANG C L,et al. Dissecting expression profiles of gastric precancerous lesions and early gastric cancer to explore crucial molecules in intestinal-type gastric cancer tumorigenesis[J]. J Pathol,2020,251(2):135-146.
2025年第47卷第5期
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doi: 10.16016/j.2097-0927.202409149
  • 接收时间:2024-09-27
  • 首发时间:2026-10-30
  • 出版时间:2025-03-15
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  • 收稿日期:2024-09-27
  • 修回日期:2024-12-27
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    1陆军特色医学中心(第三军医大学大坪医院):消化内科,消化系统肿瘤精准防治重庆市重点实验室,重庆
    2陆军特色医学中心(第三军医大学大坪医院):病理科,重庆
    3重庆医科大学第一临床学院,重庆

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2种不同金属材料的力学参数
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属
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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