Hospital Nacional Daniel A Carrión, Callao, Bellavista, Peru.
Universidad Nacional Mayor de San Marcos, Lima, Peru.
BMC Gastroenterol. 2022 Apr 8;22(1):171. doi: 10.1186/s12876-022-02233-w.
Since 2003, a progressive increase in sexually transmitted infections (STI), presented as proctitis, has been described in homosexual men. In 2013 Arnold et al. described microscopic features that enable pathologists to formulate a histological diagnosis of STI related proctitis. The aim of this study is to identify the presence of Chlamydia trachomatis by immunohistochemistry in a group of patients with male to male sexual activity and pathology compatible with STI proctitis.
Cross-sectional study. The study included 54 patients with risky sexual activity and histopathology compatible with STI-proctitis according to Arnold´s recommendations. The Chlamydia trachomatis identification was carried out retrospectively on paraffin blocks using mouse monoclonal antibodies from Santa Cruz biotechnology.
all patients were young men with male to male sexual activity, 69% were positive for HIV. The most common endoscopic presentation was rectal ulcer (61%). Basal lymphoplasmacytic inflammation and mild crypt distortion were the most common histological findings. The immunohistochemical study identified positivity for Chlamydia trachomatis in 40% (18 of 45 tested) of STI proctitis cases.
The epidemiological and endoscopic characteristics of the patients studied are similar to those previously reported. In accordance with Arnold et al., the most common histological findings were (a) mild distortion of the crypts; (b) dense and basal lymphoplasmacytic infiltrate and (c) scarcity of eosinophils. The positivity of chlamydia trachomatis in immunohistochemistry was lower than others studies that used PCR for this purpose. We did not find similar published studies to compare our results.
In summary, 54 cases of patients with STI related proctitis are presented, all of them with distinctive histological characteristics and third of the cases tested positive by IHC for Chlamydia trachomatis.
自 2003 年以来，同性恋男性中出现了一种逐渐增多的性传播感染（STI），表现为直肠炎。2013 年，Arnold 等人描述了一些微观特征，使病理学家能够对 STI 相关直肠炎进行组织学诊断。本研究的目的是在一组具有男男性行为且病理学与 STI 直肠炎相符的患者中，通过免疫组织化学方法确定沙眼衣原体的存在。
本研究为一项横断面研究。共纳入 54 例有高危性行为且病理学符合 Arnold 推荐的 STI 直肠炎的患者。采用 Santa Cruz 生物技术公司生产的鼠单克隆抗体，通过石蜡切片回顾性检测沙眼衣原体。
所有患者均为男男性行为的年轻男性，69%的患者 HIV 阳性。最常见的内镜表现为直肠溃疡（61%）。最常见的组织学发现为基底淋巴浆细胞炎症和轻微隐窝变形。免疫组化研究发现，40%（45 例中 18 例）的 STI 直肠炎病例呈沙眼衣原体阳性。
研究患者的流行病学和内镜特征与之前的报道相似。与 Arnold 等人的研究结果一致，最常见的组织学发现是（a）隐窝轻度变形；（b）密集且基底淋巴浆细胞浸润；（c）嗜酸性粒细胞稀少。免疫组化检测沙眼衣原体的阳性率低于其他使用 PCR 检测的研究。我们没有找到类似的已发表文献来比较我们的结果。
总之，本研究共纳入 54 例 STI 相关直肠炎患者，所有患者均具有独特的组织学特征，三分之一的病例通过免疫组化检测沙眼衣原体呈阳性。
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