Ladas S D, Rokkas T, Georgopoulos S, Kitsanta P, Liatsos C, Eustathiadou P, Karameris A, Spiliadi C, Raptis S A
Second Department of Internal Medicine, Evangelismos Hospital, Athens University, Greece.
Dig Dis Sci. 1999 Jun;44(6):1156-60. doi: 10.1023/a:1026624206987.
Follicular gastritis is an important histological entity, because it may progress to overt gastric MALT lymphoma. However, there is no universal agreement on whether there is any correlation of follicular gastritis with histological features of the antral mucosa or on the prevalence of follicular gastritis. To shed further light on these issues, we studied antral biopsies obtained from 735 adult patients, who had participated in six consecutive clinical trials. They included 348 patients with duodenal ulcer, 82 with gastric ulcer, and 305 with nonulcer dyspepsia. The Sydney classification system of gastritis was used, using a score of 0-3 to grade degree and activity of inflammation, gland atrophy, intestinal metaplasia, and H. pylori colonization density. Follicular gastritis was defined as prominent lymphoid follicles with no lymphoepithelial lesion. None of the H. pylori-negative patients (N = 159) had follicular gastritis. Among H. pylori-positive patients, 80/340 (23.5%) with duodenal ulcer, 5/77 (6.5%) with gastric ulcer, and 20/159 (12.6%) with nonulcer dyspepsia had follicular gastritis (P < 0.001). Multivariate discriminant analysis selected the following four significant predictor variables for follicular gastritis (Wilks lambda = 0.91, chi2 = 70.6, df = 4, P < 0.001): gastritis sum score, atrophic gastritis, age of the patient, and disease. The prevalence of follicular gastritis was linearly correlated (gamma = 24.55 - 0.98chi, r = -0.62, F1,11 = 6.12, P = 0.03) with the age groups of the 576 H. pylori-positive patients studied. In conclusion, follicular gastritis is highly correlated with H. pylori-caused severe, active gastritis. It is mostly prevalent in the young H. pylori-infected patients with duodenal ulcer.
滤泡性胃炎是一种重要的组织学实体，因为它可能进展为明显的胃黏膜相关淋巴组织淋巴瘤。然而，关于滤泡性胃炎与胃窦黏膜组织学特征是否存在关联以及滤泡性胃炎的患病率，目前尚无普遍共识。为了进一步阐明这些问题，我们研究了735名成年患者的胃窦活检标本，这些患者连续参加了六项临床试验。其中包括348例十二指肠溃疡患者、82例胃溃疡患者和305例非溃疡性消化不良患者。采用悉尼胃炎分类系统，用0至3分对炎症程度和活动度、腺体萎缩、肠化生以及幽门螺杆菌定植密度进行分级。滤泡性胃炎定义为有突出的淋巴滤泡且无淋巴上皮病变。159例幽门螺杆菌阴性患者均无滤泡性胃炎。在幽门螺杆菌阳性患者中，340例十二指肠溃疡患者中有80例（23.5%）、77例胃溃疡患者中有5例（6.5%）、159例非溃疡性消化不良患者中有20例（12.6%）患有滤泡性胃炎（P<0.001）。多变量判别分析为滤泡性胃炎选择了以下四个显著预测变量（威尔克斯λ=0.91，卡方=70.6，自由度=4，P<0.001）：胃炎总分、萎缩性胃炎、患者年龄和疾病。在研究的576例幽门螺杆菌阳性患者中，滤泡性胃炎的患病率与年龄组呈线性相关（γ=24.55 - 0.98χ，r=-0.62，F1,11 = 6.12，P = 0.03）。总之，滤泡性胃炎与幽门螺杆菌引起的严重活动性胃炎高度相关。它最常见于年轻的幽门螺杆菌感染的十二指肠溃疡患者。
