Wang Cheng-Xin, Liu Li-Jiang, Guan Jing, Zhao Xiao-Ling
Department of Pathology and Pathophysiology, School of Medicine and Life Sciences, Jianghan University, Wuhan 430056, Hubei Province, China.
World J Gastroenterol. 2005 Feb 7;11(5):686-9. doi: 10.3748/wjg.v11.i5.686.
To investigate the ultrastructural and morphological changes of non-specific duodenitis (NSD) in an attempt to grade them according to the extent of the lesions.
Biopsies were taken from the mucosa of duodenal bulb of 44 patients selected from the patients undergoing upper gastrointestinal endoscopy for epigastric discomforts. From each patient, two pinch biopsies on the same area were obtained from duodenal bulb. One was for scanning electron microscopy and the other was stained with hematoxylin-eosin, Warthin-Starry silver and both were then examined under light microscope. A total of 12 specimens (three from each degree of the normal and I-III of NSD diagnosed and graded by histology) selected from the 44 patients were dehydrated, critical point dried, coated with gold palladium and examined under a JEOL JSM-30 scanning electron microscope (SEM) at 20 kV.
According to the ultrastructural morphologic changes, non-specific duodenitis was divided into normal (as control group), mild, moderate and severe degrees according to results of SEM. The normal villi of duodenal bulb were less than 0.2 mm. There were inflammation cells, occasionally red blood cells and macrophages on the mucosal epithelial surface. Erosion and desquamation of epithelium could be seen. Three cases (25%, 3/12) had gastric metaplasia and Helicobacter pylori (H pylori) infection could be found in 5 cases (41.67%, 5/12) in duodenal bulb mucosa. The most distinctive feature was the ulcer-like defect on the surface of epithelial cells.
Non-specific duodenitis is a separate entity disease caused by different factors. SEM is of value as an aid in the diagnosis of mucosal diseases of duodenum.
研究非特异性十二指肠炎症（NSD）的超微结构和形态学变化，试图根据病变程度对其进行分级。
从因上腹部不适接受上消化道内镜检查的患者中选取44例，取十二指肠球部黏膜活检组织。从每位患者的十二指肠球部同一区域获取两块钳取活检组织。一块用于扫描电子显微镜检查，另一块用苏木精-伊红染色、Warthin-Starry银染色，然后在光学显微镜下检查。从44例患者中选取12个标本（正常及NSD的I-III级，每个级别各3个，均经组织学诊断和分级），进行脱水、临界点干燥、镀钯处理，然后在JEOL JSM-30扫描电子显微镜（SEM）下以20 kV电压进行检查。
根据超微结构形态学变化，通过SEM结果将非特异性十二指肠炎症分为正常（作为对照组）、轻度、中度和重度。十二指肠球部正常绒毛长度小于0.2 mm。黏膜上皮表面有炎症细胞，偶尔可见红细胞和巨噬细胞。可见上皮糜烂和脱落。3例（25%，3/12）有胃化生，十二指肠球部黏膜5例（41.67%，5/12）可检测到幽门螺杆菌（H pylori）感染。最显著的特征是上皮细胞表面的溃疡样缺损。
非特异性十二指肠炎症是由不同因素引起的一种独立疾病。SEM对十二指肠黏膜疾病的诊断有辅助价值。
