Helicobacter heilmannii gastritis:: a histological and immunohistochemical trait
Helicobacter heilmannii gastritis:: a histological and immunohistochemical trait
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DOI：
10.1136/jcp.54.10.774
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发表时间：
2001-10-01
影响因子：
3.4
通讯作者：
Francavilla, A
中科院分区：
文献类型：
--
作者：
Ierardi, E;Monno, RA;Francavilla, A
目的胃窦活检进行了审查，在一个为期10年的时间，以确定从这个地理区域有症状的受试者的幽门螺杆菌的患病率，并与其存在的独特的组织病理学和免疫组化features. Methods活检7926有症状的患者进行了审查。用苏木精和伊红对10个连续切片进行常规组织学染色。另外10张切片用革兰氏染色法进行螺旋菌染色。当怀疑为海氏血吸虫时，用亚甲蓝对另外10个连续切片进行染色，以获得均匀的着色。通过免疫组织化学分析来自受孤立的H heilmannii或H pylori胃炎影响的患者的相同数量的切片，以评估淋巴聚集体/粘膜淋巴细胞克隆性结果：H heilmannii的患病率为0.1%，（8/7926），而幽门螺杆菌存在于60.7%的患者（4813/7926）。在8例H heilmannii阳性患者中，2例同时发现两种螺旋杆菌。在所有仅感染H heilmannii的受试者中，观察到独特的组织学（淋巴细胞渗出到胃小凹）。海氏H氏胃炎的常见特征为类蜂窝状聚集体、慢性粘膜炎症伴斑片状活动、上皮粘液缺乏。免疫组化没有发现不同的淋巴细胞克隆模式之间的幽门螺杆菌和H heilmannii胃炎：CD 20阳性细胞主要集中在中心的聚集体和粘膜浸润，而CD 3阳性细胞普遍存在于滤泡的周边。只有幽门螺杆菌胃炎表现出显着增加TNF-α阳性基质cells. Conclusion，这些数据表明，一个不寻常的淋巴细胞反应，与入侵的小凹腔的倾向，是一个独特的组织病理学方面的H heilmannii慢性胃炎，虽然在一个更大的系列进一步的研究是必要的，以证实这一事实。然而，淋巴细胞克隆与幽门螺杆菌感染中发现的克隆在性质上没有区别。此外，与H heilmannii相比，H pylori引起更强烈的TNF-α释放，表明对这两种生物体存在不同的炎症反应。
Aim-Biopsies of the gastric antrum were reviewed over a period of 10 years to determine the prevalence of Helicobacter heilmannii in symptomatic subjects from this geographical area and to relate its presence to distinctive histopathological and immunohistochemical features.Methods-Biopsies from 7926 symptomatic patients were reviewed. Ten serial sections were stained with haematoxylin and eosin for conventional histology. Another 10 sections were stained with the Gram method for spiral bacteria. When H heilmannii was suspected, 10 additional serial sections were stained with methylene blue to obtain homogeneous colouring. An equal number of sections from patients affected by isolated H heilmannii or H pylori gastritis were analysed by immunohistochemistry to evaluate lymphoid aggregate/mucosal lymphocyte clonality (CD20 and CD3) and tumour necrosis factor alpha (TNF-a) in stromal cells.Results-The prevalence of H heilmannii was 0.1% (eight of 7926), whereas H pylori was present in 60.7% of patients (4813 of 7926). In two of the eight H heilmannii positive patients both helicobacters were found. In all subjects infected by H heilmannii only, distinctive histology (lymphocyte exudation into gastric foveolae) was seen. Lymphoid aggregates, chronic mucosal inflammation with patchy activity, and the absence of epithelial mucus depletion were regular features of H heilmannii gastritis. Immunohistochemistry did not reveal different lymphocyte clonal patterns between H pylori and H heilmannii gastritis: CD20 positive cells were predominant in the centre of aggregates and mucosal infiltrates, whereas CD3 positive cells were prevalent at the periphery of follicles. Only H pylori gastritis showed a significant increase in TNF-alpha positive stromal cells.Conclusion-These data suggest that an unusual lymphocyte reaction, with the tendency to invade the foveolar lumen, is a distinctive histopathological aspect of H heilmannii chronic gastritis, although further studies in a larger series are necessary to confirm this fact. Nevertheless, lymphocyte clones do not differ qualitatively from those found in H pylori infection. Moreover, compared with H heilmannii, H pylori provokes a more intense release of TNF-a, suggesting that different inflammatory responses exist to these two organisms.