幽门螺杆菌相关性胃炎和幽门螺杆菌非相关性胃炎中淋巴滤泡的意义

SIGNIFICANCE OF LYMPHOID FOLLICLES IN HELICOBACTER PYLORI ASSOCIATED GASTRITIS AND HELICOBACTER PYLORI NONASSOCIATED GASTRITIS

探讨幽门螺杆菌相关性胃炎中淋巴滤泡的发生率、分布及其相关病变，并评价其与临床病理学的关系。方法应用快速尿素酶试验、ＨＥ、Ｗ－Ｓ银染及ＡＢ－ＰＡＳ染色技术进行分析。结果幽门螺杆菌相关性胃炎组（ＨＰＡＧ）的淋巴滤泡（ＬＦ）发生率非常显著地高于幽门螺杆菌非相关性胃炎组（ＨＰＮＡＧ）（Ｐ＜０．０００１）。正常粘膜罕见ＬＦ。ＨＰＡＧ中的部分病人可见到ＬＦ扩大或融合、数量增加及滤泡中心细胞（ＦＣＣ）核分裂指数增加。结论ＬＦ是ＨＰＡＧ的特征性有用标记。ＬＦ及淋巴细胞广泛浸润是胃粘膜局部免疫反应形式。ＬＦ及淋巴细胞过度增殖可能是胃原发性ＭＡＬＴ淋巴瘤的危险因素。

Objective To investigate the prevalence and distribution and related lesions of lymphoid follicle (LF) in gastric biopsy specimens with Helicobacter pylori infection and to evaluate their relationship with clinical pathology.Methods Gastric biopsy specimens from 1798 cases of Helicobacter pylori associated gastritis(HPAG),382 cases of Helicobacter pylori nonassociated gastritis (HPNAG),220 cases of normal gastric mucosa were examined by HE,W-S,AB-PAS and fast urease test.Results Very marked difference in number of LF was found between HPAG and HPNAG (P<0.0001).Multiude of LF,expansion or confluence of LF,increased fission index of FCC (follicular center cells) were observed in some cases of HPAG.LF were seldomly seen in normal gastric mucosa.Conclusions LF is a conspicuous useful morphological marker for HPAG.LF and diffuse lymphocytic infiltration represent mucosal local immune reactions.Over hyperplasia of LF can be a risk factor of gastric MALT-lymphocytoma.