《病理学》消化系统疾病：胃炎-胃溃疡-肝炎
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（胃癌、肝癌）
This is the normal appearance of the stomach, which has been opened along the greater curvature. The esophagus is at the left. In the fundus can be seen the lesser curvature. Just beyond the antrum is the pylorus emptying into the first portion of duodenum is at the lower right.
The normal gastric wall in fundus. There are mucosa, muscularis propria, submucoma, muscularis and sera.
ຫໍສະໝຸດ Baidu
+ ↓表面黏液 细胞
+ 1.胃小凹
+ 2.固有层 （胃底腺）
The gastric fundal epithelium has long tubular glands that are lined by pink-staining parietal cells as well as mucus cells.
1.消化性溃疡
（1)病理变化（2)并发症
2.病毒性肝炎
七、消化系统疾 病
3.门脉性肝硬化
4.胃癌、食管癌和大肠癌
5.原发性肝癌
（1)基本病理变化（2)临床病理类 型和病变特点
（1)病因（2)病理变化（3)临床病 理联系
病理类型和病理变化
病理类型和病理变化肉眼和组织 学类型
➢ 慢性萎缩性胃炎 ➢ 消化性溃疡病 ➢ 病毒性肝炎 ➢ 肝硬化 ➢ 消化系统常见肿瘤
+ 1.主细胞 + 2.壁细胞 + 3.颈黏液细
胞
The gastric antral epithelium has long pits with shorter glands than the fundus.
部位：胃窦部>胃其他部位 病变：
多呈灶性或弥漫状 胃镜观：病变胃粘膜充血、水肿、呈淡红色
The normal appearance of the gastric fundus on upper GI endoscopy is shown below at the left, with the normal duodenal appearance at the right.
This is the normal appearance of the gastric antrum extending to the pylorus at the right of center. The first portion of the duodenum (duodenal bulb) is at the far right.
降低 常有 无
正常 无 高
病变
两型病变基本类似
胃镜观：胃粘膜由正常的橘红色变为灰色或灰绿色
粘膜层变薄、皱襞变浅、甚至消失
粘膜下血管清晰可见
表面呈细颗粒状，偶有出血及糜烂 光镜观 ①胃粘膜固有腺体萎缩
②粘膜有肠上皮化生或假幽门腺化生 完全化生（杯状细胞和吸收细胞）
不完全化生 大肠型 （只有杯状细胞） 小肠型
In the endoscopic views above, the normal appearance of the pylorus is seen at the left, with the first portion of the duodenum at the right.
This is the normal appearance of the gastric fundal mucosa, with short pits lined by pale columnar mucus cells leading into long glands which contain bright pink parietal cells that secrete hydrochloric acid.
A型和B型慢性萎缩性胃炎比较表
A型
B型
自身免疫
HP感染（60%~70%)
胃体或胃底部弥漫性分布 胃窦部多灶性分布
抗内因子抗体抗壁细胞抗体
（胃液和血清）
血清胃泌素水平 胃内分泌细胞G细胞的增生 血清中自身抗体 胃酸分泌
阳性
高 有 阳性（＞90%） 明显降低
阴性
低 无 无 中度降低或正常
血清VitB12水平 恶性贫血 伴发消化性溃疡
Superficial chronic gastritis with H.pylori infection shows the inflammation limited in the portion of mucosa occupied by the foveolae.
病因与发病机制 病变部位
肠型胃癌
③固有膜内淋巴细胞、浆细胞浸润
Endoscopic view of chronic atrophic gastritis. The mucosa of the antrum is pale, thinner. The undermucosal blood vessels can be seen. A normal picture of antrum as control in the right.
Advanced chronic atrophic gastritis with H. Pylori infection shows a whole thickness mucosa inflammation and decrease of glands.
有时可见点状出血和糜烂 表面有灰黄或灰白色粘液性渗出物覆盖 光镜观：浅层粘膜（粘膜层上1/3） 灶性或弥漫分布 胃粘膜充血、水肿、表浅上皮坏死脱落 固有层有淋巴细胞、浆细胞浸润 结局： 大多经治疗或合理饮食而痊愈，少数转为慢 性萎缩性胃炎
Chronic superficial gastritis. Note the inflammatory infiltrates limit the upper one third of the mucosa.
This is the normal appearance of the stomach, which has been opened along the greater curvature. The esophagus is at the left. In the fundus can be seen the lesser curvature. Just beyond the antrum is the pylorus emptying into the first portion of duodenum is at the lower right.
The normal gastric wall in fundus. There are mucosa, muscularis propria, submucoma, muscularis and sera.
ຫໍສະໝຸດ Baidu
+ ↓表面黏液 细胞
+ 1.胃小凹
+ 2.固有层 （胃底腺）
The gastric fundal epithelium has long tubular glands that are lined by pink-staining parietal cells as well as mucus cells.
1.消化性溃疡
（1)病理变化（2)并发症
2.病毒性肝炎
七、消化系统疾 病
3.门脉性肝硬化
4.胃癌、食管癌和大肠癌
5.原发性肝癌
（1)基本病理变化（2)临床病理类 型和病变特点
（1)病因（2)病理变化（3)临床病 理联系
病理类型和病理变化
病理类型和病理变化肉眼和组织 学类型
➢ 慢性萎缩性胃炎 ➢ 消化性溃疡病 ➢ 病毒性肝炎 ➢ 肝硬化 ➢ 消化系统常见肿瘤
+ 1.主细胞 + 2.壁细胞 + 3.颈黏液细
胞
The gastric antral epithelium has long pits with shorter glands than the fundus.
部位：胃窦部>胃其他部位 病变：
多呈灶性或弥漫状 胃镜观：病变胃粘膜充血、水肿、呈淡红色
The normal appearance of the gastric fundus on upper GI endoscopy is shown below at the left, with the normal duodenal appearance at the right.
This is the normal appearance of the gastric antrum extending to the pylorus at the right of center. The first portion of the duodenum (duodenal bulb) is at the far right.
降低 常有 无
正常 无 高
病变
两型病变基本类似
胃镜观：胃粘膜由正常的橘红色变为灰色或灰绿色
粘膜层变薄、皱襞变浅、甚至消失
粘膜下血管清晰可见
表面呈细颗粒状，偶有出血及糜烂 光镜观 ①胃粘膜固有腺体萎缩
②粘膜有肠上皮化生或假幽门腺化生 完全化生（杯状细胞和吸收细胞）
不完全化生 大肠型 （只有杯状细胞） 小肠型
In the endoscopic views above, the normal appearance of the pylorus is seen at the left, with the first portion of the duodenum at the right.
This is the normal appearance of the gastric fundal mucosa, with short pits lined by pale columnar mucus cells leading into long glands which contain bright pink parietal cells that secrete hydrochloric acid.
A型和B型慢性萎缩性胃炎比较表
A型
B型
自身免疫
HP感染（60%~70%)
胃体或胃底部弥漫性分布 胃窦部多灶性分布
抗内因子抗体抗壁细胞抗体
（胃液和血清）
血清胃泌素水平 胃内分泌细胞G细胞的增生 血清中自身抗体 胃酸分泌
阳性
高 有 阳性（＞90%） 明显降低
阴性
低 无 无 中度降低或正常
血清VitB12水平 恶性贫血 伴发消化性溃疡
Superficial chronic gastritis with H.pylori infection shows the inflammation limited in the portion of mucosa occupied by the foveolae.
病因与发病机制 病变部位
肠型胃癌
③固有膜内淋巴细胞、浆细胞浸润
Endoscopic view of chronic atrophic gastritis. The mucosa of the antrum is pale, thinner. The undermucosal blood vessels can be seen. A normal picture of antrum as control in the right.
Advanced chronic atrophic gastritis with H. Pylori infection shows a whole thickness mucosa inflammation and decrease of glands.
有时可见点状出血和糜烂 表面有灰黄或灰白色粘液性渗出物覆盖 光镜观：浅层粘膜（粘膜层上1/3） 灶性或弥漫分布 胃粘膜充血、水肿、表浅上皮坏死脱落 固有层有淋巴细胞、浆细胞浸润 结局： 大多经治疗或合理饮食而痊愈，少数转为慢 性萎缩性胃炎
Chronic superficial gastritis. Note the inflammatory infiltrates limit the upper one third of the mucosa.