Guarner Jeannette, Bartlett Jeanine, Whistler Toni, Pierce-Smith Daphne, Owens Marilyn, Kreh Rachel, Czinn Steven, Gold Benjamin D
Infectious Disease Pathology Activity, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta GA 30333, USA.
J Pediatr Gastroenterol Nutr. 2003 Sep;37(3):309-14. doi: 10.1097/00005176-200309000-00019.
Active gastritis, gastric mucosal atrophy and intestinal metaplasia are lesions associated with Helicobacter pylori infection. Atrophy and intestinal metaplasia are only seen in adults.
We describe pediatric patients with atrophy and metaplasia, and compare the inflammatory response in these patients to controls.
As part of a multicenter study of pediatric H. pylori infection, gastric biopsy specimens obtained during diagnostic upper endoscopy of 19 H. pylori-infected children and 45 uninfected controls were reviewed and graded by using the updated Sydney system. The inflammatory response was characterized using immunohistochemistry for T lymphocytes, B lymphocytes, and macrophages, and TUNEL assay for apoptosis.
Histology of H. pylori-infected and control biopsy specimens showed active gastritis in 32% and 2% respectively (P = 0.002). Mild intestinal metaplasia was found in 4 H. pylori-infected children, in two of whom it appeared to be accompanied by atrophy. Specimens from patients with H. pylori infection contained increased numbers of B lymphocytes in lymphoid nodules, and apoptosis in the superficial epithelium and inflammatory cells. T lymphocytes and macrophages appeared in similar numbers in specimens from controls and infected patients.
We describe intestinal metaplasia associated with H. pylori infection in children. Since atrophy usually precedes intestinal metaplasia in adults, we suggest that atrophy exists in children. High numbers of B lymphocytes and apoptosis in the surface epithelium are seen in patients with H. pylori infection and may be related to the development of atrophy and intestinal metaplasia.
活动性胃炎、胃黏膜萎缩和肠化生是与幽门螺杆菌感染相关的病变。萎缩和肠化生仅见于成年人。
我们描述患有萎缩和化生的儿科患者，并将这些患者的炎症反应与对照组进行比较。
作为一项关于儿童幽门螺杆菌感染的多中心研究的一部分，对19名幽门螺杆菌感染儿童和45名未感染对照儿童在诊断性上消化道内镜检查期间获取的胃活检标本，采用更新后的悉尼系统进行回顾和分级。使用T淋巴细胞、B淋巴细胞和巨噬细胞的免疫组织化学以及凋亡的TUNEL检测来表征炎症反应。
幽门螺杆菌感染组和对照组活检标本的组织学检查分别显示32%和2%有活动性胃炎（P = 0.002）。在4名幽门螺杆菌感染儿童中发现轻度肠化生，其中2名似乎伴有萎缩。幽门螺杆菌感染患者的标本中，淋巴小结内B淋巴细胞数量增加，浅表上皮和炎症细胞中有凋亡现象。对照组和感染患者标本中T淋巴细胞和巨噬细胞的数量相似。
我们描述了儿童中与幽门螺杆菌感染相关的肠化生。由于成年人中萎缩通常先于肠化生出现，我们推测儿童中也存在萎缩。幽门螺杆菌感染患者的表面上皮中可见大量B淋巴细胞和凋亡现象，这可能与萎缩和肠化生的发生有关。
