溃疡Ulcer · 前胃 · 消化系统 · NTP ntp-0213

依据美国国家毒理学计划(NTP)Nonneoplastic Lesion Atlas 整理 · 中文译文与诊断建议 · 仅供科研使用,不用于临床诊断

一句话结论:溃疡(ulcer,Figure 1、Figure 2、Figure 3、Figure 4、Figure 5)定义为全部上皮细胞层缺失并延伸至黏膜下层,而糜烂(erosion)是黏膜浅层上皮层的缺失。
诊断要点:前胃溃疡只要存在即应诊断。应根据病变的范围、数量和深度进行分级。继发性病变,如水肿、炎症和邻近上皮的增生,除非是病变的显著组成部分或被认为是原发性病变(例如,增生先于溃疡发生),否则不单独诊断。

病变描述

溃疡(ulcer,Figure 1、Figure 2、Figure 3、Figure 4、Figure 5)定义为全部上皮细胞层缺失并延伸至黏膜下层,而糜烂(erosion)是黏膜浅层上皮层的缺失。溃疡底部及邻近组织中的炎症以及邻近上皮的增生是非常常见的伴随所见。前胃溃疡形成是一种常见的背景性所见。前胃是溃疡最常见的发生部位,但溃疡可发生于整个胃肠道。前胃溃疡形成可由灌胃事故引起,也可能与受试物相关(尤其是当受试物为刺激性物质时)。然而,在许多情况下,溃疡的确切原因并不清楚。

诊断与分级建议(NTP 共识)

前胃溃疡只要存在即应诊断。应根据病变的范围、数量和深度进行分级。继发性病变,如水肿、炎症和邻近上皮的增生,除非是病变的显著组成部分或被认为是原发性病变(例如,增生先于溃疡发生),否则不单独诊断。如果坏死上皮仍然存在并附着于其下方的固有层,则诊断上皮坏死而非溃疡(见 Stomach, Forestomach - Necrosis)。相关链接:Stomach, Forestomach - Necrosis

图谱

溃疡(前胃)组织学图谱 1
图 1 · 溃疡 · 来源:NTP NNL Atlas
溃疡(前胃)组织学图谱 2
图 2 · 溃疡 · 来源:NTP NNL Atlas

英文原文

展开 NTP 官方英文描述与建议

Comment:
An ulcer ( Figure 1 , Figure 2 , Figure 3 , Figure 4 , and Figure 5 ) is defined as the loss of all epithelial cell layers extending through to the submucosa, whereas an erosion is the loss of superficial epithelial layers of the mucosa. Inflammation at the base of an ulcer and in adjacent tissue and hyperplasia of the adjacent epithelium are very common associated findings. Forestomach ulceration is a common background finding. The forestomach is the most common location for ulcers, but they may occur throughout the gastrointestinal tract. Ulceration of the forestomach can be caused by gavage accidents, or they may be treatment related (especially when the test article is an irritant). However, in many cases the exact cause of ulcers is not known.

Recommendation:
Ulcers of the forestomach should be diagnosed whenever present. They should be graded based on the extent, number, and depth of the lesions. Secondary lesions, such as edema, inflammation, and hyperplasia of the adjacent epithelium, are not diagnosed separately unless they are prominent components of the lesion or they are considered a primary lesion (e.g., the hyperplasia occurred prior to the ulcer). Necrosis of the epithelium is diagnosed instead of ulcer if the necrotic epithelium is still present and attached to the underlying lamina propria (see Stomach, Forestomach - Necrosis ). Related Links: Stomach, Forestomach - Necrosis

来源与引用

原始条目:https://ntp.niehs.nih.gov/atlas/nnl/alimentary-system/stomach-forestomach/Ulcer

图谱总目录:NTP Nonneoplastic Lesion Atlas。 内容属美国联邦政府作品(公有领域),可引用;引用时请标注来源。

建议引用格式:NTP Nonneoplastic Lesion Atlas. Ulcer (stomach-forestomach). LabSmart 中文版: https://www.labsmart.cn/ntp/stomach-forestomach-ulcer.html

中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#stomach-forestomach-ulcer

上皮变性上皮增生(局灶性/弥漫性)上皮非典型增生出血囊肿坏死