Department of Ophthalmology, Université de Montréal.
Department of Microbiology and Infectious Disease, Université de Sherbrooke.
Ophthalmic Plast Reconstr Surg. 2021;37(3S):S1-S5. doi: 10.1097/IOP.0000000000001729.
Helicobacter pylori could theoretically induce ocular adnexal lymphoma (OAL) via 2 mechanisms: the first is that of infection within the ocular adnexa and the second is that of infection within the gastric mucosa, leading to the malignant transformation of lymphocytes that migrate to the ocular adnexa, forming a primary "ectopic" cancer. This study investigated if an association exists between gastric H. pylori or ocular adnexal H. pylori and OAL.
Prospective case-control study including cases with OAL and controls with nonlymphomatous pathologies. Gastric H. pylori infection was assessed via serologic antibody testing. Ocular adnexal infection was assessed via polymerase chain reaction testing for H. pylori and Chlamydia psittaci within ocular adnexal samples.
Seventy-two patients were enrolled, of whom 18 had lymphoma and 54 nonlymphomatous pathologies. H. pylori antibodies were present in 5 cases (28%) and 18 controls (33%) (95% CI, 0.24%-2.50%, p = 0.78). All ocular adnexal specimens were negative for H. pylori and C. psittaci infection. The only relevant statistically significant difference between cases and controls was a history of gastric ulcer (95% CI, 1.23%-44.80%, p = 0.03).
In the study's population, infection of gastric mucosa with H. pylori does not appear to influence the development of OAL. Also, H. pylori or C. psittaci infection within the ocular adnexa does not appear to influence the development of OAL. In the study's practice, authors do not recommend antibiotic administration or routine gastroscopy for patients with OAL. The authors do recommend referral of OAL patients with gastric symptoms to a gastroenterologist.
幽门螺杆菌（H. pylori）理论上可以通过两种机制诱导眼附属器淋巴瘤（OAL）：第一种是眼附属器内感染，第二种是胃黏膜内感染，导致迁移至眼附属器的淋巴细胞恶性转化，形成原发性“异位”癌。本研究旨在探讨胃 H. pylori 或眼附属器 H. pylori 是否与 OAL 相关。
本研究为前瞻性病例对照研究，纳入 OAL 患者和非淋巴瘤性病变患者作为对照。通过血清学抗体检测评估胃 H. pylori 感染，通过聚合酶链反应（PCR）检测眼附属器样本中 H. pylori 和鹦鹉热衣原体（C. psittaci）评估眼附属器感染。
共纳入 72 例患者，其中 18 例患有淋巴瘤，54 例患有非淋巴瘤性病变。5 例（28%）患者和 18 例对照（33%）存在 H. pylori 抗体（95%可信区间，0.24%-2.50%，p=0.78）。所有眼附属器标本均未检测到 H. pylori 和 C. psittaci 感染。病例和对照之间唯一具有统计学显著差异的因素是胃溃疡史（95%可信区间，1.23%-44.80%，p=0.03）。
在本研究人群中，胃黏膜 H. pylori 感染似乎不会影响 OAL 的发生。此外，眼附属器内 H. pylori 或 C. psittaci 感染似乎也不会影响 OAL 的发生。在本研究实践中，作者不建议对 OAL 患者常规给予抗生素治疗或行胃镜检查。作者建议将有胃部症状的 OAL 患者转诊至胃肠病专家处。
