Badmos K B, Ojo O S, Olasode O S, Arigbabu A O
Department of Morbid Anatomy and Forensic Medicine,Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State.
Niger Postgrad Med J. 2009 Dec;16(4):264-7.
Morphologic changes seen in the endoscopic biopsies are dynamic and could be predictive of more important sequelae of chronic H. pylori gastritis such as gastric carcinoma and lymphoma. The objective of the study was to review the biopsy appearances of endoscopic gastroduodenal biopsies using the updated Sydney System of classification in order to throw some light on the biology of gastroduodenitis.
A retrospective review of all endoscopic gastroduodenal biopsies received in the department of Morbid Anatomy of Obafemi Awolowo University Teaching Hospitals Complex between 1994 and 2003 was undertaken. Grading of the chronicity, activity, atrophy, H. pylori density and metaplasia were done using the updated Sydney System of classification and grading.
A total of 1047 gastric and 47 duodenal biopsies from 1047 patients were reviewed. There was evidence of significant chronic gastritis in 98.1% of the gastric biopsies and in 78.0% of these, H. pylori was the main identifiable aetiological agent. Marked atrophic changes and intestinal metaplasia that are known to predispose to gastric malignances were seen in 4.9% and 9.3% of our cases respectively. Chronic duodenitis was seen in 83% of the duodenal biopsies and in 29.6%, H. pylori was seen on a background of gastric metaplasia.
The prevalence of H. pylori was high and it was the single most important aetiological factor responsible for the biopsy changes associated with chronic gastroduodenitis.
内镜活检中观察到的形态学变化是动态的，可能预示着慢性幽门螺杆菌胃炎更重要的后遗症，如胃癌和淋巴瘤。本研究的目的是使用更新后的悉尼分类系统回顾内镜下胃十二指肠活检的病理表现，以便对胃十二指肠炎的生物学特性有所了解。
对1994年至2003年间奥巴费米·阿沃洛沃大学教学医院综合病理解剖科接收的所有内镜下胃十二指肠活检进行回顾性研究。使用更新后的悉尼分类和分级系统对慢性程度、活动度、萎缩程度、幽门螺杆菌密度和化生进行分级。
共回顾了1047例患者的1047份胃活检和47份十二指肠活检。98.1%的胃活检有明显的慢性胃炎证据，其中78.0%的主要可识别病因是幽门螺杆菌。在我们的病例中，分别有4.9%和9.3%出现了已知易导致胃癌的明显萎缩性变化和肠化生。83%的十二指肠活检有慢性十二指肠炎，29.6%在胃化生背景下发现幽门螺杆菌。
幽门螺杆菌的患病率很高，是导致与慢性胃十二指肠炎相关活检变化的最重要单一病因。
