人胆囊炎标本中幽门螺杆菌的检出及意义

Detection of Helicobacter pylori from gallbladder mucosa in patients with chronic cholecystitis

目的:探讨慢性胆囊炎患者胆囊内是否存在幽门螺杆菌(H pylori). 方法:对手术切除的病理确诊为慢性胆囊炎的胆囊石蜡标本用W-S银染色法筛选和抗H pylori抗体进行免疫组化染色,对手术切除标本胆囊黏膜DNA 用H pylori尿素酶A, B基因引物行PCR扩增,研究慢性胆囊炎胆囊中H pylori 感染的情况. 结果:524例胆囊炎手术标本蜡块中有71例(13.55%)镜下观察到类似H pylori的细菌,其中37例(7.1%)有H pylori抗体染色阳性细菌,81例慢性胆囊炎手术后新鲜标本胆囊黏膜DNA PCR扩增,11例(13.6%)尿素酶A、B基因皆阳性,4例仅有尿素酶A基因阳性,7例仅有尿素酶B基因阳性. 结论:部分慢性胆囊炎患者胆囊内确有H pylori存在.

AIM: To study whether Helicobacter pylori (H pylori) located in gallbladders of chronic cholecystitis. METHODS: Using Warthy-Starry (W-S) stain and immu-nohistochemical stain with anti-H pylori antibody, we screened paraffin specimens in 524 cases of cholecystitis. Helicobacter pylori'urease gene A (HPUA) and Helicobacter pylori urease gene B (HPUB) were analyzed by polymerase chain reaction (PCR) in the fresh tissue specimens in 81 cases of cholecystitis. RESULTS: H py/ori-like bacteria were found in 13.55% of gallbladders in cholecystitis patients using W-S stains; Meanwhile, positive bacteria for H pylori antibody were also found in 7.1% of gallbladder in patients with cholecystitis using immunohistochemistry. Both of HPUA and HPUB were positive in 11 of 81 gallbladders by PCR, only 4 cases positive for HPUA, and 7 cases with HPUB positive. CONCLUSION: H pylori certainly exists in gallbladders in some patients with chronic cholecystitis.