Beware! Does this mean you have stomach cancer? Pay attention to these situations!

Author: Guo Shanlan, deputy chief physician of Ziyang First People's Hospital

Reviewer: Dai Chuanqiang, Chief Physician, Ziyang First People's Hospital

Gastroscopy is an increasingly popular method for visually detecting upper digestive tract diseases. Some people may find some lesions during gastroscopy. At this time, the doctor will often tell you that you need to take a little "flesh" and send it to the pathology department for a pathological examination.

You must be curious about what kind of journey this little piece of "meat" in your stomach will take in the pathology department. Let's find out today.

Figure 1 Copyright image, no permission to reprint

At this point, the "little meat" has transformed into a gastroscopy biopsy tissue slice, and the pathologist can observe it through a microscope, and the diagnosis results will be presented in the pathology report in your hand. In this report, in addition to the "cancer" and "non-cancer" issues that you are most concerned about, you will also see some dazzling descriptions such as activity (-/+~+++), intestinal metaplasia (-/+~+++), atrophy (-/+~+++), HP (Helicobacter pylori) (-/+~+++), as well as low-grade intraepithelial neoplasia, high-grade intraepithelial neoplasia, etc.

Today I’m going to talk to you about what these “-” and “+” mean in the gastroscopy report.

Don't worry, it will be translated for you below .

Chronic gastritis is the most common gastric lesion. Pathologists often observe and evaluate the lesions in five aspects, including the degree of chronic inflammation, activity, atrophy, intestinal metaplasia and HP (Helicobacter pylori) infection. Each aspect is divided into none, mild, moderate and severe according to the severity, corresponding to "- ", "+ ", "++" and "+++" respectively.

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1. Chronic inflammation

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There are more lymphocytes and plasma cells in the gastric mucosa. The more these two types of cells there are, the more severe the chronic inflammation is.

2. Activity

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The more neutrophils there are in the gastric mucosa, the more severe the degree of inflammatory activity. The presence of active inflammation highly suggests Helicobacter pylori infection.

3. Atrophy

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When the number of intrinsic glands in the gastric mucosa decreases or is replaced by intestinal metaplasia cells, it is called "atrophy". Chronic gastritis can be divided into chronic atrophic gastritis and chronic non-atrophic gastritis according to whether there is atrophy or not.

4. Intestinal metaplasia

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Under inflammatory stimulation, normal gastric mucosal epithelial cells are replaced by intestinal epithelial cells, which is called "intestinal metaplasia" (abbreviated as "intestinal metaplasia"). The intestinal metaplasia epithelium (the bubble-like empty bright areas in the picture above) is a cell similar to a highball glass.

5. HP ( Helicobacter pylori )

Figure 7 Copyright image is not authorized for reproduction

Helicobacter pylori (a slightly curved, blue-stained, short rod-shaped bacillus that aggregates on the mucosal surface as shown in the figure above) is the main cause of chronic active gastritis and is closely related to gastric diseases such as peptic ulcer, cancer, and lymphoma.

After today's introduction, do you have a better understanding of the "fantastic journey" of the "little meat" in the stomach in the pathology department? Do you have a better understanding of the gastric biopsy pathology report in your hand? Here I still want to remind you that although you can roughly understand the report, you still need to take the gastroscopy report and pathology report in your hand to see a gastroenterologist to help you interpret and develop a treatment plan for you!