幽门螺杆菌相关胃疾病与胃窦黏膜淋巴组织增生
Helicobacter pylori associated gastric diseases and lymphoid tissue hyperplasia in gastric antral mucosa.
作者信息
Chen X Y, Liu W Z, Shi Y, Zhang D Z, Xiao S D, Tytgat G N J
机构信息
Department of Pathology, Renji Hospital, Shanghai Second Medical University, Shanghai Institute of Digestive Disease, Shanghai 200001, China.
出版信息
J Clin Pathol. 2002 Feb;55(2):133-7. doi: 10.1136/jcp.55.2.133.
AIM
To investigate the relation between Helicobacter pylori associated gastroduodenal diseases and lymphoid tissue hyperplasia in the antral mucosa and to pursue its evolution after eradication of H pylori.
METHODS
Gastric antral biopsy specimens were obtained from 438 patients with H pylori positive gastroduodenal diseases (185 chronic gastritis, 69 gastric ulcer, and 184 duodenal ulcer) and 50 H pylori negative healthy controls. Lymphoid follicles and aggregates were counted and other pathological features were scored according to the updated Sydney system for classification of chronic gastritis. After a course of anti-H pylori treatment, biopsy specimens were obtained at four to six weeks, 12 months, and 24 months in the chronic gastritis patient group.
RESULTS
The total prevalence of lymphoid follicles and aggregates in the biopsies was 79.9% (350 of 438; 95% confidence intervals (CI), 0.76 to 0.84). The prevalence and density of lymphoid follicles and aggregates were significantly different in the various gastroduodenal diseases. The highest prevalence (89.9%; 95% CI, 0.83 to 0.97) and density (0.82) of lymphoid follicles and aggregates occurred in patients with gastric ulcers. The lowest prevalence of lymphoid follicles and aggregates was found in patients with chronic gastritis (74.6%; 95% CI, 0.68 to 0.81), and the lowest density of lymphoid follicles and aggregates (0.56) was seen in patients with duodenal ulcers. The prevalence and density of lymphoid follicles and aggregates correlated strongly with the activity and severity of gastric antral mucosal inflammation. The eradication of H pylori resulted in a decrease in the prevalence and density of lymphoid follicles and aggregates.
CONCLUSION
The prevalence and density of lymphoid follicles and aggregates in gastric antral mucosal biopsies correlated closely with H pylori infection.
目的
研究幽门螺杆菌相关性胃十二指肠疾病与胃窦黏膜淋巴组织增生之间的关系，并探讨根除幽门螺杆菌后其演变情况。
方法
从438例幽门螺杆菌阳性的胃十二指肠疾病患者（185例慢性胃炎、69例胃溃疡和184例十二指肠溃疡）及50例幽门螺杆菌阴性的健康对照者获取胃窦活检标本。根据更新的悉尼系统对慢性胃炎进行分类，计数淋巴滤泡和淋巴集结，并对其他病理特征进行评分。在慢性胃炎患者组中，经过一个疗程的抗幽门螺杆菌治疗后，于4至6周、12个月和24个月获取活检标本。
结果
活检标本中淋巴滤泡和淋巴集结的总患病率为79.9%（438例中的350例；95%置信区间（CI），0.76至0.84）。不同胃十二指肠疾病中淋巴滤泡和淋巴集结的患病率及密度有显著差异。淋巴滤泡和淋巴集结的患病率最高（89.9%；95%CI，0.83至0.97）及密度最高（0.82）出现在胃溃疡患者中。淋巴滤泡和淋巴集结的患病率最低见于慢性胃炎患者（74.6%；95%CI，0.68至0.81），而淋巴滤泡和淋巴集结密度最低（0.56）见于十二指肠溃疡患者。淋巴滤泡和淋巴集结的患病率及密度与胃窦黏膜炎症的活动度和严重程度密切相关。根除幽门螺杆菌导致淋巴滤泡和淋巴集结的患病率及密度降低。
结论
胃窦黏膜活检中淋巴滤泡和淋巴集结的患病率及密度与幽门螺杆菌感染密切相关。
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