梅毒螺旋体免疫组织化学在人类肠道螺旋体病中呈阳性。
Treponema pallidum Immunohistochemistry is positive in human intestinal Spirochetosis.
作者信息
Graham Rondell P, Naini Bita V, Shah Sejal S, Arnold Christina A, Kannangai Rajesh, Torbenson Michael S, Lam-Himlin Dora M
机构信息
Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave. Suite 27-061C7 CHS, Los Angeles, CA, 90095, USA.
出版信息
Diagn Pathol. 2018 Jan 22;13(1):7. doi: 10.1186/s13000-017-0676-6.
BACKGROUND
Human intestinal spirochetosis (IS) has been recognized for decades, but whether it represents commensalism or a pathogenic process remains controversial. IS is diagnosed on routine stains with confirmation by silver stains but these stains are labor intensive and slow to read. We evaluated the Treponema pallidum immunostain as a diagnostic adjunct for IS.
METHODS
We retrieved biopsies from 33 patients with IS for this study. Each case was tested by Warthin-Starry (WS) and T. pallidum immunohistochemistry (IHC). Species specific genotyping was performed in 3 cases.
RESULTS
Patients with IS ranged from 22 to 82 years without gender predilection. IS involved normal (n = 15), and inflamed (n = 5) mucosa and colonic polyps (n = 13). Warthin-Starry and T. pallidum IHC were positive in all cases including both species of Brachyspira. Six (18%) symptomatic patients were treated for IS, and experienced resolution. In patients diagnosed with incidental IS on cancer screening (n = 5), follow up biopsies, without therapy, were negative for IS. T. pallidum IHC required 75 min less hands-on time than WS for performance and was faster to interpret.
CONCLUSIONS
T. pallidum IHC can be used to confirm the diagnosis of IS and is easier to perform and faster to interpret than WS.
背景
人类肠道螺旋体病（IS）已被认识数十年，但它是代表共生现象还是致病过程仍存在争议。IS通过常规染色诊断，并经银染色确认，但这些染色操作繁琐且读片耗时。我们评估了梅毒螺旋体免疫染色作为IS的辅助诊断方法。
方法
我们为本研究检索了33例IS患者的活检标本。每例均进行Warthin-Starry（WS）染色和梅毒螺旋体免疫组织化学（IHC）检测。对3例进行了种属特异性基因分型。
结果
IS患者年龄在22至82岁之间，无性别倾向。IS累及正常黏膜（n = 15）、炎症黏膜（n = 5）和结肠息肉（n = 13）。Warthin-Starry染色和梅毒螺旋体IHC在所有病例中均呈阳性，包括两种短螺旋体属。6例（18%）有症状的患者接受了IS治疗，并症状缓解。在癌症筛查时偶然诊断为IS的患者（n = 5）中，未经治疗的随访活检标本IS呈阴性。梅毒螺旋体IHC操作所需的实际动手时间比WS少75分钟，且读片更快。
结论
梅毒螺旋体IHC可用于确诊IS，且比WS更易于操作和读片。
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