Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, State University of New York Downstate Medical Center, Brooklyn, NY, USA.
Department of Pathology, Children's Hospital at Downstate, State University of New York Downstate Medical Center, Brooklyn, NY, USA.
Helicobacter. 2018 Jun;23(3):e12487. doi: 10.1111/hel.12487. Epub 2018 Apr 25.
Helicobacter pylori (Hp) are the most common agents causing gastric mucosal injury worldwide. Foveolar hyperplasia is a key component of the stomach's reaction to injury. This study examines histopathologic characteristics associated with Helicobacter pylori and with non- Helicobacter pylori-associated gastropathy in children and adolescents, and compares the prevalence of foveolar hyperplasia among these disease subgroups and normal control subjects.
Eighty-one gastric antral and corpus biopsies from subjects 2-19 years of age were studied. Twenty-two subjects with Helicobacter pylori gastritis were compared to 23 with non-Helicobacter pylori gastropathy and to 36 controls (normal biopsies). Foveolar length, full mucosal thickness, and the foveolar length: full mucosal thickness ratio were derived by a morphometric technique previously developed to analyze adult gastric tissue.
Compared to controls, Helicobacter pylori gastritis demonstrated significant increases in antral foveolar length (P < .0001), full mucosal thickness (P < .0001), as well as corpus foveolar length (P < .05) and corpus full mucosal thickness (P < .05). Non-Helicobacter pylori-associated gastropathy also was characterized by increased antral foveolar length (P < .0001) and full mucosal thickness (P < .001) but corresponding corpus measurements did not differ from controls. Antral foveolar length in non-Helicobacter pylori gastropathy was increased, when compared to Helicobacter pylori gastritis (P < .05), while corpus values were not. The non-Helicobacter pylori gastropathy group demonstrated increased antral foveolar length: full mucosal thickness ratios, compared with Helicobacter pylori gastritis (P < .001) and with normal controls (P < .0001).
An objective, quantitative approach to measuring foveolar hyperplasia in adults was successfully applied to pediatric biopsies and yielded a richer characterization of gastric pathology in children. Foveolar hyperplasia appears to be a generalized phenomenon in the presence of pediatric Helicobacter pylori gastritis but is limited to the antrum in non-Helicobacter pylori gastropathy.
幽门螺杆菌（Hp）是全世界引起胃黏膜损伤的最常见病原体。 滤泡增生是胃对损伤的反应的关键组成部分。 本研究检查了与儿童和青少年的幽门螺杆菌和非幽门螺杆菌相关胃病相关的组织病理学特征，并比较了这些疾病亚组和正常对照组中滤泡增生的患病率。
研究了 81 名年龄在 2-19 岁的胃窦和胃体活检标本。 将 22 名幽门螺杆菌胃炎患者与 23 名非幽门螺杆菌胃病患者和 36 名对照（正常活检）进行比较。 采用先前开发的一种形态计量技术来分析成人胃组织，得出了滤泡长度，全黏膜厚度以及滤泡长度：全黏膜厚度比值。
与对照组相比，幽门螺杆菌胃炎患者的胃窦部滤泡长度（P <.0001），全黏膜厚度（P <.0001）以及胃体部滤泡长度（P <.05）和胃体部全黏膜厚度（P <.05）均显着增加。 非幽门螺杆菌相关胃病也表现为胃窦部滤泡长度（P <.0001）和全黏膜厚度（P <.001）增加，但相应的胃体测量值与对照组无差异。 与幽门螺杆菌胃炎相比，非幽门螺杆菌胃病患者的胃窦部滤泡长度增加（P <.05），而胃体部则没有。 与幽门螺杆菌胃炎（P <.001）和正常对照组（P <.0001）相比，非幽门螺杆菌胃病组胃窦部滤泡长度：全黏膜厚度比值增加。
成功地将成人滤泡增生的客观，定量方法应用于儿科活检，并对儿童的胃病理学进行了更深入的描述。 滤泡增生似乎是儿童幽门螺杆菌胃炎的普遍现象，但在非幽门螺杆菌胃病中仅限于胃窦。
