Uhlig H H, Tannapfel A, Mössner J, Jedwilayties S, Deutscher J, Müller D M, Kiess W, Richter T
Hospital for Children and Adolescents, Institute of Pathology, University of Leipzig, Germany.
Scand J Gastroenterol. 2003 Jul;38(7):701-6. doi: 10.1080/00365520310003039.
The pathohistological features of Helicobacter pylori-associated gastritis in children and adolescents are less well understood than they are in adults. The aim of the study was to compare histological parameters of H. pylori-infected children with those of adults.
The retrospective study compared histological features of 111 children (mean age 10.8 +/- 3.8). Three paediatric age groups were analysed and the findings were compared with those of 111 adults (mean age 64.2 +/- 12.1). Degree of chronicity and activity of inflammation, mucus depletion and regeneration of foveolar epithelium by regenerating epithelium and H. pylori colonization were scored in antral biopsies.
The histological parameters in children, i.e. degree of chronicity, activity of gastritis and the summed gastritis score, were not significantly different compared to those in adults. Replacement of foveolar epithelium by regenerating epithelium was significantly larger in adults compared to that of paediatric patients. The rate of low-grade mucus depletion and of the strongest degree of H. pylori colonization was higher in children than in adults. Children with antral nodularity had significantly higher histological score values.
The histological differences between paediatric patients and adults are focused on signs of chronic inflammation and regeneration. Our results imply that antral nodularity is an important sign of highest-grade gastritis, especially in young children.
与成人相比，儿童和青少年幽门螺杆菌相关性胃炎的病理组织学特征了解较少。本研究的目的是比较幽门螺杆菌感染儿童与成人的组织学参数。
这项回顾性研究比较了111名儿童（平均年龄10.8±3.8岁）的组织学特征。分析了三个儿童年龄组，并将结果与111名成人（平均年龄64.2±12.1岁）的结果进行比较。对胃窦活检组织中的慢性炎症程度、炎症活动度、黏液减少情况以及由再生上皮引起的小凹上皮再生和幽门螺杆菌定植情况进行评分。
儿童的组织学参数，即慢性炎症程度、胃炎活动度和胃炎总分，与成人相比无显著差异。与儿童患者相比，成人中再生上皮替代小凹上皮的情况明显更严重。儿童中低度黏液减少和幽门螺杆菌最强定植程度的发生率高于成人。有胃窦结节的儿童组织学评分值显著更高。
儿童患者与成人之间的组织学差异集中在慢性炎症和再生的迹象上。我们的结果表明，胃窦结节是重度胃炎的一个重要标志，尤其是在幼儿中。
