幽门螺杆菌感染与胃粘膜相关淋巴组织的相关性研究

RELATION BETWEEN HELICOBACTER PYLORI INFECTION AND GASTRIC MUCOSA-ASSOCIATED LYMPHOID TISSUE

对排除自身免疫性疾病 ,经胃镜诊断为慢性浅表性胃炎 (CSG)、慢性萎缩性胃炎 (CAG)和消化性溃疡 (PU)共 86例病人的活检胃粘膜进行Warthin Starry银染和快速尿素酶试验 ,以确定有否幽门螺杆菌 (Hp)感染 ;用HE染色和免疫组织化学染色方法观察T、B淋巴细胞的增生以及淋巴滤泡形成。结果表明 ,在Hp感染病人中 (5 9例 ,6 8 6 % ) ,有淋巴滤泡者占 35 6 % (2 1/ 5 9) ,发现 6例淋巴上皮病变。而无Hp感染的病人均无淋巴滤泡。Hp感染的有无和感染程度与淋巴细胞浸润、淋巴滤泡形成和慢性活动性胃炎呈显著相关 (P <0 0 1)。结果提示 ,Hp感染与粘膜相关淋巴组织 (MALT)淋巴瘤的发生有关。临床上有必要对存在胃淋巴滤泡 /MALT的病人进行Hp根除治疗。

Eighty six patients with chronic superficial gastritis, atrophic gastritis and peptic ulcer without autoimmune diseases underwent gastroscopy and biopsy in the gastric antrum and body. Hp was identified by histopathological analysis (Warthin Starry silver stains) and rapid urease test (RUT). Lymphoid tissue was observed by HE stain and immunohistochemistry method. Results showed that Hp infection was found in 68 6% of the patients.Lymphoid follicles were present in 35 6% of the Hp positive patients ,and no lymphoid follicles were found in the Hp negative patients.In six Hp positive patients,Lymphoepithelial lesions were found.Hp infection was closely associated with gastric mucosal lymphoid infiltration,lymphoid follicles and active inflammation( P <0 01)?This significant phenomenon provides a potential basic background in which MALT lymphoma might develop.It is our belief that it is necessary to eradicate Hp in the patients with gastric mucosal lymphoid follicles/MALT to prevent the pathological development of MALT lymphoma.