Jhala D, Jhala N, Lechago J, Haber M
Department of Pathology, Baylor College of Medicine, and The Methodist Hospital, Houston, Texas 77030, USA.
Mod Pathol. 1999 May;12(5):534-8.
We analyzed 2 antral and 1 corpus full-thickness random endoscopic gastric mucosal samples obtained from 946 patients with duodenal ulcers (6077 biopsies) and from 281 patients with nonsteroidal anti-inflammatory drug-associated gastric ulcers (1794 biopsies). We stained tissue sections with hematoxylin and eosin and Warthin-Starry silver stain and immunostained them with polyclonal antibodies against Helicobacter pylori. Hematoxylin- and eosin-stained sections from 6 patients with Helicobacter heilmannii (18 biopsies) and 23 randomly selected patients with H. pylori (68 biopsies) were evaluated and semiquantitated for the presence of acute inflammation, chronic inflammation, glandular atrophy, intestinal metaplasia, H. pylori, H. heilmannii, lymphoid follicles, or vasodilatation. Additional specimens were obtained for H. pylori culture, a CLO test, and serologic examination. H. heilmannii was detected in 6 (0.49%) of 1227 patients (14 [0.18%] of 7871 biopsies). Of these, 4 (0.42%) of 946 were patients with duodenal ulcers (9 [0.15%] of 6077 biopsies), and 2 (0.71%) of 281 were patients with nonsteroidal anti-inflammatory drug-associated gastric ulcers (5 [0.28%] of 1794 biopsies). We found H. heilmannii with hematoxylin and eosin stain, Warthin-Starry stain, and immunoperoxidase stain for H. pylori. Culture for H. pylori was negative in the four patients with duodenal ulcers. The CLO and serologic tests were positive in three of five and five of five patients, respectively. Our results indicate that H. heilmannii, like H. pylori, is associated with peptic ulcer disease (both active and inactive gastritis) and that it preferentially colonizes the gastric antrum. The severity of the H. heilmannii-associated gastritis is less intense and lymphoid aggregates are less common than in H. pylori-associated gastritis. Morphologic detection seems to be the method of choice for detecting H. heilmanni. Immunoperoxidase stain specific for H. pylori also stains H. heilmannii, indicating cross-reacting antigenic epitopes between H. heilmannii and H. pylori.
我们分析了从946例十二指肠溃疡患者（6077份活检样本）和281例非甾体抗炎药相关性胃溃疡患者（1794份活检样本）获取的2份胃窦全层和1份胃体全层随机内镜下胃黏膜样本。我们用苏木精和伊红染色、Warthin-Starry银染色对组织切片进行染色，并用抗幽门螺杆菌的多克隆抗体进行免疫染色。对6例海氏螺杆菌感染患者（18份活检样本）和23例随机选取的幽门螺杆菌感染患者（68份活检样本）的苏木精和伊红染色切片进行评估，并对急性炎症、慢性炎症、腺体萎缩、肠化生、幽门螺杆菌、海氏螺杆菌、淋巴滤泡或血管扩张的存在情况进行半定量分析。另外获取样本用于幽门螺杆菌培养、CLO试验和血清学检查。在1227例患者中，有6例（0.49%）检测出海氏螺杆菌（在7871份活检样本中有14例[0.18%]）。其中，946例十二指肠溃疡患者中有4例（0.42%）（在6077份活检样本中有9例[0.15%]），281例非甾体抗炎药相关性胃溃疡患者中有2例（0.71%）（在1794份活检样本中有5例[0.28%]）。我们通过苏木精和伊红染色、Warthin-Starry染色以及幽门螺杆菌免疫过氧化物酶染色检测到了海氏螺杆菌。4例十二指肠溃疡患者的幽门螺杆菌培养结果为阴性。CLO试验和血清学检查在5例患者中分别有3例和5例呈阳性。我们的结果表明，海氏螺杆菌与幽门螺杆菌一样，与消化性溃疡病（包括活动性和非活动性胃炎）相关，且它优先定植于胃窦。与幽门螺杆菌相关性胃炎相比，海氏螺杆菌相关性胃炎的严重程度较轻，淋巴聚集也较少见。形态学检测似乎是检测海氏螺杆菌的首选方法。幽门螺杆菌特异性免疫过氧化物酶染色也能染出海氏螺杆菌，这表明海氏螺杆菌与幽门螺杆菌之间存在交叉反应性抗原表位。
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