疱疹病毒性食管炎内镜表现特征及病因检测16例分析

Endoscopic characteristics and etiological examinations of viral esophagitis： a report of 16 cases

目的探讨病毒性食管炎内镜和病理表现特点以及病因检测方法。方法回顾分析16例病毒性食管炎的临床资料，内镜、病理及免疫组化检查结果。结果16例病毒性食管炎内镜下表现为单发或多发性食管溃疡，溃疡灶集中在食管胸上、中段。溃疡表浅为较规则的圆形或椭圆形，溃疡面清洁，与周围组织界限清楚。病理学表现为特征为鳞状上皮黏膜内有退变坏死组织，伴溃疡形成，大量中性粒细胞和淋巴细胞浸润，毛细血管增生，肉芽组织形成，基底细胞反应性增生。16例患者活检组织的蜡块标本单纯疱疹病毒检测结果阳性，巨细胞病毒、EB病毒、疱疹病毒8型均为阴性。结论毒性食管炎具有特殊的内镜和病理表现，对活检标本进行免疫组化检测能够确定病因。

Objective To evaluate the endoscopic and pathologic characteristics and etiological examination of viral esophagitis. Methods The data of 16 patients with viral esophagitis, including endoscopic, pathological and immunohistochemical findings were retrospectively studied. Results Endoscopic findings of viral esophagitis were characterized by single or multiple round and oval ulcers, located at the upper and middle esophagus. The surface of the ulcer was clean, and the boundary was distinct. Pathologic findings included degeneration and necrosis in squamous epithelium, accompanied by ulcer, infiltration of neutrophils and lymphocytes, hyperplasia of capillaries and basal cells and formation of granulation tissues. Immunocytochemical examination showed HSV-1 was positive in biopses, while CMV, EBV, HHV8 were negetive. Conclusion Viral esophagtitis exhibited distinctive endoscopic and pathological features, and etiology can be confirmed by immunohistochemical examinations.