Klimpfinger M
Institut für Pathologie, Universität Graz.
Wien Klin Wochenschr. 1994;106(17):550-5.
The histological gastritis classification according to the Sydney system is a standardisation of different classification systems used so far. It is based on the principles of etiology, topography and course of the disease, as well as morphological changes of the gastric mucosa in gastritis. Histological examination represents the practical gold standard of Helicobacter pylori detection and can be used on routinely formaldehyde-fixed biopsy material and hematoxylin-eosin stained slides. Histology is therefore also of practical diagnostic value for the control of the eradication therapy of Helicobacter pylori. The sensitivity of histological Helicobacter detection is on average higher than that of other methods including microbiology. Nevertheless, additional bacterial cultures are useful in cases of therapy resistant Helicobacter pylori infections. For routine diagnosis histological Helicobacter pylori detection is often combined with the so-called rapid urease test, which can be used in the endoscopy outpatient department, frequently offering an interim diagnosis of Helicobacter pylori infection. Furthermore, histological examination enables not only exact gastritis classification with Helicobacter pylori detection, but also the diagnosis of precancerous lesions and gastric carcinomas, as well as primary gastric lymphomas. Biopsy material for histological examination can be taken during the routinely necessary gastroscopic examination of patients with gastric symptoms without much additional burden.
根据悉尼系统进行的组织学胃炎分类是对迄今为止使用的不同分类系统的标准化。它基于病因、病变部位、疾病进程以及胃炎时胃黏膜形态变化的原则。组织学检查是检测幽门螺杆菌的实际金标准，可用于常规甲醛固定的活检材料和苏木精-伊红染色切片。因此，组织学对幽门螺杆菌根除治疗的控制也具有实际诊断价值。组织学检测幽门螺杆菌的敏感性平均高于包括微生物学在内的其他方法。然而，对于耐治疗的幽门螺杆菌感染病例，额外的细菌培养是有用的。对于常规诊断，组织学检测幽门螺杆菌通常与所谓的快速尿素酶试验相结合，该试验可在内镜门诊使用，经常能提供幽门螺杆菌感染的初步诊断。此外，组织学检查不仅能通过检测幽门螺杆菌进行准确的胃炎分类，还能诊断癌前病变、胃癌以及原发性胃淋巴瘤。在对有胃部症状的患者进行常规必要的胃镜检查时，可采集用于组织学检查的活检材料，而不会增加太多额外负担。
