Division of Gastrointestinal Pathology, Caris Research Institute, Caris Life Sciences, Irving, TX 75039, USA.
Mod Pathol. 2011 Apr;24(4):556-63. doi: 10.1038/modpathol.2010.221. Epub 2010 Dec 17.
There is limited information about normal eosinophil counts in the gastric mucosa. The purpose of this study was to evaluate the histopathology of 60 patients whose biopsies showed increased eosinophils in the gastric mucosa. We also investigated the eosinophil content in gastric biopsies from normal controls (matched for age, sex, and zip code), from patients with Helicobacter pylori gastritis, and patients with Crohn's disease. Eosinophils were counted in five random high-power fields (HPFs) and reported in eosinophils/mm(2). Involvement of the muscularis mucosae or submucosa, sheets of eosinophils, and infiltration of the gastric epithelium were also evaluated. The median eosinophil count in the study patients was 539 eosinophils/mm(2); mean±SD=653±418 eosinophils/mm(2); range 127-2108. Sheets of eosinophils were seen in 38 patients, 27 showed involvement of the muscularis mucosae or submucosa. There were 7 patients without epithelial infiltration by eosinophils, whereas 34 were tallied as rare and 19 were scored as abundant. No study patient had no evidence of H. pylori. The mean eosinophil count for the 135 normal controls was 15.5±16.8 SD eosinophils/mm(2) (range 0-110); in the 93 controls with H. pylori gastritis the mean eosinophil count was 25±32.6 SD eosinophils/mm(2) (range 0-219); and for the 53 controls with Crohn's disease it was 31.4±44.4 SD eosinophils/mm(2) (range 0-203). There were no significant differences between the counts in biopsies from the antrum and corpus, and no significant variations by age, geographic location, or season. This study confirms that, in the United States population, the normal gastric eosinophilic counts are usually <38 eosinophils/mm(2). We recommend 'histological eosinophilic gastritis' for the diagnosis of gastric biopsies that show an average density ≥127 eosinophils/mm(2) (or ≥30 eosinophils per HPF) in at least five HPFs in the absence of known associated causes of eosinophilia.
关于胃黏膜中正常嗜酸性粒细胞计数的信息有限。本研究的目的是评估 60 例胃黏膜嗜酸性粒细胞增多患者的组织病理学特征。我们还调查了来自正常对照者（年龄、性别和邮政编码匹配）、幽门螺杆菌胃炎患者和克罗恩病患者的胃活检嗜酸性粒细胞含量。在五个随机高倍视野（HPF）中计数嗜酸性粒细胞，并以嗜酸性粒细胞/mm²报告。还评估了黏膜肌层或黏膜下层的累及、嗜酸性粒细胞片层和胃上皮细胞的浸润。研究患者的中位嗜酸性粒细胞计数为 539 嗜酸性粒细胞/mm²；平均值±标准差=653±418 嗜酸性粒细胞/mm²；范围 127-2108。38 例患者可见嗜酸性粒细胞片层，27 例患者显示黏膜肌层或黏膜下层累及。7 例患者无嗜酸性粒细胞上皮浸润，而 34 例被计为罕见，19 例被计为丰富。没有研究患者没有幽门螺杆菌的证据。135 例正常对照者的平均嗜酸性粒细胞计数为 15.5±16.8 嗜酸性粒细胞/mm²（范围 0-110）；93 例幽门螺杆菌胃炎对照者的平均嗜酸性粒细胞计数为 25±32.6 嗜酸性粒细胞/mm²（范围 0-219）；53 例克罗恩病对照者的平均嗜酸性粒细胞计数为 31.4±44.4 嗜酸性粒细胞/mm²（范围 0-203）。胃窦和胃体活检的嗜酸性粒细胞计数无显著差异，且年龄、地理位置或季节无显著变化。本研究证实，在美国人群中，正常胃嗜酸性粒细胞计数通常<38 嗜酸性粒细胞/mm²。我们建议“组织学嗜酸性粒细胞性胃炎”用于诊断胃活检，在至少五个 HPF 中显示平均密度≥127 嗜酸性粒细胞/mm²（或每 HPF 至少 30 个嗜酸性粒细胞），且无已知的嗜酸性粒细胞增多相关原因。
