Testoni P A, Colombo E, Cattani L, Longhi M, Bagnolo F, Lella F, Buizza M, Scelsi R
Institute of Internal Medicine, University of Milan, Italy.
J Clin Gastroenterol. 1996 Apr;22(3):182-5. doi: 10.1097/00004836-199604000-00006.
It has been suggested that there may be a correlation between Helicobacter pylori (Hp) infection and precancerous lesions of the stomach. However, histological evaluation of bacterial colonization in chronic atrophic gastritis shows a relatively low prevalence of the microorganism, which does not support the hypothesis. The aim of our study was to investigate the Hp serology in 95 patients with chronic gastritis with antral atrophy, with (27 cases) and without (68 cases) intestinal metaplasia, and without Helicobacter-like organisms in antral and corpus biopsy specimens. For all subjects, serum anti-Hp immunoglobulin IgG was identified by a fluorescent immunoenzymatic method (Helori-test; Eurospital), and mucosal atrophy and activity were graded histologically (Sydney System score). The serum Hp-antibody status documented the presence of current bacterial infections in 64 of 95 (67.4%) patients and previous infections in another 17 subjects. In only 14.7% of cases was there no evidence of current or previous infection. These subjects had less severe mucosal atrophy and lower inflammatory scores. In addition, there were no cases of intestinal metaplasia in such subjects. The high prevalence of Hp infection confirms the primary role of the microorganism in the pathogenesis of chronic gastritis with antral atrophy, although the bacterium is no longer present in the advanced stages of such disease. The histological evaluation of Hp colonization following the criteria of the Sydney System appears from our study to underestimate the true prevalence of the infection in the stomach when there is mucosal atrophy.
有人提出幽门螺杆菌（Hp）感染与胃的癌前病变之间可能存在关联。然而，对慢性萎缩性胃炎中细菌定植的组织学评估显示该微生物的患病率相对较低，这并不支持这一假说。我们研究的目的是调查95例伴有胃窦萎缩的慢性胃炎患者的Hp血清学情况，其中27例伴有肠化生，68例不伴有肠化生，且胃窦和胃体活检标本中无幽门螺杆菌样生物体。对于所有受试者，通过荧光免疫酶法（Helori检测；Eurospital）鉴定血清抗Hp免疫球蛋白IgG，并对黏膜萎缩和活性进行组织学分级（悉尼系统评分）。血清Hp抗体状态表明，95例患者中有64例（67.4%）存在当前细菌感染，另有17例存在既往感染。仅有14.7%的病例没有当前或既往感染的证据。这些受试者的黏膜萎缩较轻，炎症评分较低。此外，这些受试者中没有肠化生病例。Hp感染的高患病率证实了该微生物在伴有胃窦萎缩的慢性胃炎发病机制中的主要作用，尽管在该疾病的晚期阶段该细菌已不存在。根据悉尼系统标准对Hp定植进行的组织学评估在我们的研究中似乎低估了存在黏膜萎缩时胃内感染的真实患病率。
