Feeley K M, Heneghan M A, Stevens F M, McCarthy C F
Department of Pathology, University College Hospital, Galway, Ireland.
J Clin Pathol. 1998 Mar;51(3):207-10. doi: 10.1136/jcp.51.3.207.
To investigate the prevalence of lymphocytic gastritis in patients with coeliac disease.
Gastric biopsies from 70 patients with coeliac disease were examined by light microscopy for the presence of lymphocytic gastritis, defined as 25 or more intraepithelial lymphocytes/100 gastric columnar epithelial cells.
Lymphocytic gastritis was found in seven cases. Positive cases had a mean of 32.1 intraepithelial lymphocytes/100 columnar cells, compared with a mean of 13.9 in negative cases, and 5.15 in noncoeliac controls. No differences were found for age, sex, gastric corpus or antrum, or degree of inflammation in the gastric lamina propria. All intraepithelial lymphocytes were of T cell lineage. Cases not showing lymphocytic gastritis did however show significantly increased gastric intraepithelial lymphocytes compared with non-coeliac controls. Eighteen of 70 cases were positive for Helicobacter pylori, and four of seven cases of lymphocytic gastritis were H pylori positive; no significant difference was observed between H pylori positive and negative patients. Three cases had concomitant ulcerative enteritis, of which none showed lymphocytic gastritis, while five cases had concomitant enteropathy associated T cell lymphoma, of which one showed lymphocytic gastritis.
Lymphocytic gastritis occurred in 10% of patients with coeliac disease. Cases without lymphocytic gastritis nevertheless showed increased gastric intraepithelial lymphocytes. Coeliac disease may on occasion be a diffuse lymphocytic enteropathy occurring in response to gluten. Lymphocytic gastritis outside coeliac disease may involve an immune response to luminal antigens, such as H pylori, not unlike the response to gluten in patients with coeliac disease.
调查乳糜泻患者淋巴细胞性胃炎的患病率。
对70例乳糜泻患者的胃活检组织进行光学显微镜检查，以确定是否存在淋巴细胞性胃炎，其定义为每100个胃柱状上皮细胞中存在25个或更多的上皮内淋巴细胞。
发现7例淋巴细胞性胃炎。阳性病例每100个柱状细胞的上皮内淋巴细胞平均为32.1个，阴性病例平均为13.9个，非乳糜泻对照为5.15个。在年龄、性别、胃体或胃窦，或固有层炎症程度方面未发现差异。所有上皮内淋巴细胞均为T细胞谱系。然而，未显示淋巴细胞性胃炎的病例与非乳糜泻对照相比，胃上皮内淋巴细胞显著增加。70例中有18例幽门螺杆菌阳性，7例淋巴细胞性胃炎中有4例幽门螺杆菌阳性；幽门螺杆菌阳性和阴性患者之间未观察到显著差异。3例合并溃疡性肠炎，均未显示淋巴细胞性胃炎，5例合并肠病相关T细胞淋巴瘤，其中1例显示淋巴细胞性胃炎。
10%的乳糜泻患者发生淋巴细胞性胃炎。无淋巴细胞性胃炎的病例胃上皮内淋巴细胞仍增加。乳糜泻可能偶尔是一种针对麸质的弥漫性淋巴细胞性肠病。乳糜泻以外的淋巴细胞性胃炎可能涉及对腔内抗原（如幽门螺杆菌）的免疫反应，这与乳糜泻患者对麸质的反应并无不同。
