Lymphocytic gastritis—relationship to Campylobacter pylori infection
Lymphocytic gastritis—relationship to Campylobacter pylori infection
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淋巴细胞性胃炎——与幽门弯曲杆菌感染的关系
作者：
M. Dixon;J. Wyatt;D. Burke;B. Rathbone
已经证实存在一种独特形式的慢性胃炎，其特征是成熟T淋巴细胞对表面和坑衬上皮的显着浸润。在 382 名活动性慢性胃炎患者中发现了 17 例（4·5%）。淋巴细胞性胃炎病例的上皮内淋巴细胞计数显着高于来自一系列通常形式的活动性 B 型慢性胃炎患者的性别和年龄匹配的对照。此外，淋巴细胞性胃炎组表现出不寻常的内镜检查结果，即胃体糜烂和“凸起病变”。这种表现以前被描述为“痘痘样”胃炎。只有 7 名患者 (41%) 活检呈幽门螺杆菌阳性，而活动性慢性胃炎的阳性率超过 90%，但在接受测试的 11 例患者中，除 2 例外，所有患者均具有幽门螺杆菌感染的血清学证据。虽然这种情况的发病机制尚不清楚，但与乳糜泻的组织学相似性表明淋巴细胞性胃炎也可能代表患者对局部抗原过敏的异常反应。该抗原可能是幽门螺杆菌。
The existence of a distinctive form of chronic gastritis characterized by marked infiltration of the surface and pitlining epithelium by mature T lymphocytes has been confirmed. Seventeen cases were identified amongst 382 patients with active chronic gastritis (4·5 per cent). The cases with lymphocytic gastritis had significantly higher counts of intra‐epithelial lymphocytes than sex and age‐matched controls drawn from a series of patients with the usual form of active Type B chronic gastritis. Furthermore, the lymphocytic gastritis group exhibited unusual endoscopic findings, namely erosions and ‘raised lesions’, in the body of the stomach. Such appearances have been previously described as ‘varioliform’ gastritis. Only seven of the patients (41 per cent) had C.pylori‐positive biopsies, compared with over 90 per cent in the generality of active chronic gastritis, but all but two of the eleven cases tested had serological evidence of C. pylori infection. While the pathogenesis of this condition is unclear, the histological resemblance to coeliac disease suggests that lymphocytic gastritis might also represent an abnormal response to a local antigen to which the patient has become sensitized. It is possible that this antigen is C. pylori.