目前胃癌的发病机制尚不明确。肠型胃癌的进展过程大致可被描述为浅表性胃炎–慢性萎缩性胃炎–肠化生–肠型胃癌,其中,肠化生是这一路径中最重要的病理类型,这些年来,许多学者将研究重心聚焦于这一病理变化。经研究发现,不当的饮食习惯、吸烟、饮酒、年龄、性别、幽门螺杆菌感染、胆汁酸反流等因素都可导致正常胃黏膜出现肠化生。近年来,内镜诊断也逐渐成为研究热点,以更早更直观地发现病变并及早进行干预。本文围绕胃黏膜肠上皮化生的界定、类别划分、风险要素以及内镜下的诊断要点进行系统的阐述,目的是提升临床工作者对于该病理现象的理解程度,进而更有效地进行胃癌的早期预防与干预。The pathogenesis of gastric cancer remains incompletely understood. The progression of intestinal-type gastric cancer can be delineated as superficial gastritis, chronic atrophic gastritis, intestinal metaplasia, and ultimately intestinal-type gastric cancer. Among these stages, intestinal metaplasia represents the most pivotal pathological transformation, which has garnered significant research attention in recent years. Studies have identified multiple contributing factors to the development of intestinal metaplasia in normal gastric mucosa, including inappropriate dietary habits, smoking, alcohol consumption, age, gender, Helicobacter pylori infection, and bile reflux. In recent years, endoscopic diagnosis has emerged as a prominent research focus, enabling earlier and more direct identification of pathological changes for timely intervention. This article provides a systematic review of the definition, classification, risk factors, and endoscopic diagnostic features of gastric intestinal metaplasia, aiming to enhance clinicians’ understanding of this pathological phenomenon and facilitate more effective early prevention and intervention strategies for gastric cancer.
