蓝氏贾第鞭毛虫和幽门螺杆菌双重感染的胃肠道活检：瑞士单中心回顾性分析。

Giardia lamblia and Helicobacter pylori coinfection in gastrointestinal biopsies: A retrospective single-center analysis from Switzerland.

机构信息

Medica Institute of Clinical Pathology, Hottingerstrasse 9/11, 8032 Zurich, Switzerland.

出版信息

Ann Diagn Pathol. 2021 Aug;53:151756. doi: 10.1016/j.anndiagpath.2021.151756. Epub 2021 May 10.

DOI:10.1016/j.anndiagpath.2021.151756

PMID:33989960

Abstract

BACKGROUND

The protozoan Giardia lamblia (GL) and the bacterium Helicobacter pylori (HP) are common causes of gastrointestinal disease. Coinfection is common and has been reported in studies from Africa, Europe, North America and Asia, but data for Switzerland are scarce.

AIM

To investigate GL and HP prevalence and coinfection rate in gastrointestinal biopsies from the Zurich area of Switzerland.

METHODS

Cases were retrieved from the laboratory information system (Medica Institute of Clinical Pathology, Zurich, Switzerland). Histological slides of cases with GL were reviewed, as were the concurrent gastric biopsies, where available.

RESULTS

Between January 1, 2013 and December 31, 2020, GL was found in 88 (0.14%) of 62,402 patients with a small intestine biopsy and HP in 10,668 (15.5%) of 68,961 patients with a gastric biopsy. 74/88 (84.1%) of patients with GL had unremarkable small intestine biopsies, 13/88 (14.8%) had increased intraepithelial lymphocytes, 5/88 (5.7%) showed villous atrophy and 2/88 (2.3%) acute inflammation. 71/88 patients (80.7%) with GL had an available gastric biopsy, of which 12/71 (16.9%) were unremarkable, 28/71 (39.4%) had HP-associated gastritis, 11/71 (15.5%) showed reactive gastropathy and 1/71 (1.4%) had autoimmune gastritis.

CONCLUSION

Coinfection with HP is common in patients with GL in gastrointestinal biopsies from the Zurich area of Switzerland. Therefore, gastroenterologists should consider sampling the stomach when GL is suspected for evaluation of possible concurrent HP-associated gastritis. Likewise, pathologists should scrutinize any small intestine biopsy for the presence of GL when HP-associated gastritis is seen, and vice versa.

摘要

背景

原生动物蓝氏贾第鞭毛虫（GL）和细菌幽门螺杆菌（HP）是常见的胃肠道疾病病原体。共感染很常见，在来自非洲、欧洲、北美和亚洲的研究中都有报道，但瑞士的数据却很少。

目的

调查瑞士苏黎世地区胃肠道活检中 GL 和 HP 的流行率和共感染率。

方法

从实验室信息系统（苏黎世医学临床病理学研究所，瑞士）中检索病例。对 GL 病例的组织学切片进行了回顾，如有胃活检则同时进行了回顾。

结果

2013 年 1 月 1 日至 2020 年 12 月 31 日，62402 例小肠活检患者中发现 88 例（0.14%）GL 阳性，68961 例胃活检患者中发现 10668 例（15.5%）HP 阳性。88 例 GL 阳性患者中，74 例（84.1%）小肠活检无明显异常，13 例（14.8%）肠上皮内淋巴细胞增多，5 例（5.7%）绒毛萎缩，2 例（2.3%）急性炎症。88 例 GL 阳性患者中有 71 例（80.7%）可进行胃活检，其中 12 例（16.9%）无明显异常，28 例（39.4%）为 HP 相关胃炎，11 例（15.5%）为反应性胃病，1 例（1.4%）为自身免疫性胃炎。