Yang Yu, Xiong Wei, Wang Shiyu, Xu Jie, McNutt Michael A, Zhang Lanjing
Department of Pathology, University of Texas Medical Branch, Galveston, TX.
Department of Pathology, University of British Columbia, Vancouver, BC, Canada.
Appl Immunohistochem Mol Morphol. 2018 May/Jun;26(5):345-350. doi: 10.1097/PAI.0000000000000421.
Helicobacter pylori (HP) infection is associated with significant gastric mucosal inflammation. We aimed to determine the clinicopathologic features associated with HP in gastric biopsy.
Three hundred ninety-six gastric biopsies were evaluated including 165 HP-positive cases and 231 randomly selected HP-negative controls. HP was detected using hematoxylin and eosin (H&E), Giemsa, and immunohistochemistry staining. The univariate and multivariate analyses were conducted to study the relationship of clinicopathologic characteristics and HP infection. Among the HP-positive cases, 131 cases were confirmed by H&E staining and 34 cases were confirmed by Giemsa or immunohistochemistry staining. Compared with chronic inactive gastritis, chronic active gastritis was more likely associated with having HP detected by H&E. Males were more likely to have HP gastritis than females (odds ratio: 1.72, P=0.01). The patients who had chronic active gastritis or chronic gastritis (moderate or severe) were more likely to have HP infection than patients with mild chronic gastritis (P<0.001). Conversely, patients who had intestinal metaplasia were less likely to have HP infection than patients without intestinal metaplasia (odds ratio: 0.22, P<0.001). However, concurrent atrophic gastritis was not related to HP infection (P=0.37). HP infection history was not associated with HP infection (P=0.74).
HP detection in gastric biopsies is associated with active inflammation, male sex, and the lack of intestinal metaplasia, but not atrophic gastritis or HP infection history. Routine ancillary staining may not be required for HP detection in all biopsy specimens. We do not recommend ancillary staining for mild chronic inactive gastritis.
幽门螺杆菌（HP）感染与显著的胃黏膜炎症相关。我们旨在确定胃活检中与HP相关的临床病理特征。
对396例胃活检标本进行评估，其中包括165例HP阳性病例和231例随机选取的HP阴性对照。采用苏木精-伊红（H&E）染色、吉姆萨染色和免疫组织化学染色检测HP。进行单因素和多因素分析以研究临床病理特征与HP感染之间的关系。在HP阳性病例中，131例通过H&E染色确诊，34例通过吉姆萨染色或免疫组织化学染色确诊。与慢性非活动性胃炎相比，慢性活动性胃炎更可能通过H&E染色检测到HP。男性比女性更易患HP胃炎（优势比：1.72，P = 0.01）。患有慢性活动性胃炎或慢性（中度或重度）胃炎的患者比轻度慢性胃炎患者更易感染HP（P < 0.001）。相反，有肠化生的患者比无肠化生的患者感染HP的可能性更小（优势比：0.22，P < 0.001）。然而，并发萎缩性胃炎与HP感染无关（P = 0.37）。HP感染史与HP感染无关（P = 0.74）。
胃活检中HP检测与活动性炎症、男性以及缺乏肠化生相关，但与萎缩性胃炎或HP感染史无关。并非所有活检标本检测HP都需要常规辅助染色。对于轻度慢性非活动性胃炎，我们不建议进行辅助染色。
