Wang Xiaohong, Li Xiaopei, Ge Wenqing, Huang Jian, Li Gaiqin, Cong Yanqun, Li Fukang, Liu Zhen, Liu Zhiyan, Li Yanqing, Yuan Haipeng
Department of Gastroenterology, Taian City Central Hospital, Taian, Shandong Province, PR China.
Department of Emergency, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Ann Diagn Pathol. 2015 Apr;19(2):50-6. doi: 10.1016/j.anndiagpath.2015.02.001. Epub 2015 Feb 20.
The role of duodenal eosinophils and mast cells (MCs) in the pathogenesis of functional dyspepsia (FD) remains poorly understood. This study aimed to examine the counts and degranulation of duodenal eosinophils and MCs in FD patients to explore the association between FD and both cell types. We recruited 141 FD patients and 39 healthy controls for this study. Biopsy specimens were collected from the duodenal bulb (D1) and the descending part (D2) of the duodenum of all participants. Eosinophil counts and degranulation, and MC counts and degranulation at both sites were quantitatively evaluated by hematoxylin and eosin staining, major basic protein immunostaining, and toluidine blue staining, respectively. Receiver operating characteristic analysis was applied to evaluate the diagnostic accuracy of these parameters in identifying FD cases. We found that the eosinophil counts at D2 were considerably increased in FD patients compared with healthy controls, and that the proportion of cases with eosinophil degranulation at D2 was significantly higher in the FD group. In addition, FD patients showed significantly increased MC counts and degranulation both at D1 and D2, and receiver operating characteristic analysis further demonstrated that these parameters, in particular the degranulation of MCs, appear to be highly sensitive and specific for the identification of FD patients. Our findings suggest that the increased eosinophil counts and degranulation at D2, and the increased MC counts and degranulation at D1 and D2 may be the histologic markers of FD. MC degranulation at D1 and D2 appears to be highly sensitive and specific for FD identification.
十二指肠嗜酸性粒细胞和肥大细胞（MCs）在功能性消化不良（FD）发病机制中的作用仍知之甚少。本研究旨在检测FD患者十二指肠嗜酸性粒细胞和MCs的计数及脱颗粒情况，以探讨FD与这两种细胞类型之间的关联。我们招募了141例FD患者和39名健康对照者参与本研究。从所有参与者十二指肠球部（D1）和降部（D2）采集活检标本。分别通过苏木精-伊红染色、主要碱性蛋白免疫染色和甲苯胺蓝染色对两个部位的嗜酸性粒细胞计数及脱颗粒情况、MC计数及脱颗粒情况进行定量评估。应用受试者工作特征分析来评估这些参数在识别FD病例中的诊断准确性。我们发现，与健康对照者相比，FD患者D2处的嗜酸性粒细胞计数显著增加，且FD组中D2处出现嗜酸性粒细胞脱颗粒的病例比例明显更高。此外，FD患者D1和D2处的MC计数及脱颗粒均显著增加，受试者工作特征分析进一步表明，这些参数，尤其是MCs的脱颗粒情况，似乎对识别FD患者具有高度敏感性和特异性。我们的研究结果表明，D2处嗜酸性粒细胞计数及脱颗粒增加，以及D1和D2处MC计数及脱颗粒增加可能是FD的组织学标志物。D1和D2处的MC脱颗粒对FD识别似乎具有高度敏感性和特异性。
