免疫荧光染色检测胃黏膜活检标本中幽门螺杆菌和真菌感染的应用研究

Detection of Helicobacter pylori and Fungal Infections in Gastric Mucosal Biopsy Specimens by Immuno-fluorescence Staining

背景:幽门螺杆菌(Hp)感染是明确的胃癌危险因子,且研究发现胃癌组织有较高的真菌检出率。对于Hp和真菌感染的诊断,不同方法各有其优缺点。目的:评价免疫荧光染色对胃黏膜活检标本中Hp和真菌感染的诊断价值。方法:收集2019年9月—2020年9月在中国人民解放军东部战区总医院接受胃镜检查的450例胃癌患者的胃黏膜活检标本,分别采用免疫荧光染色、HE染色和亚甲蓝染色检测Hp感染,分别采用免疫荧光染色和PAS染色检测真菌感染,比较各染色方法的镜检表现和阳性检出率。结果:与HE染色和亚甲蓝染色相比,免疫荧光染色Hp在暗黑色背景之上呈清晰橙红色,更易于观察,检出率显著高于HE染色(49.6%对30.9%,P<0.05),与亚甲蓝染色相比无明显差异(49.6%对48.4%,P>0.05)。免疫荧光染色真菌发亮蓝色荧光,较之PAS染色菌体和背景均为红色更易于观察,检出率显著高于PAS染色(31.6%对20.2%,P<0.05)。结论:免疫荧光染色是检测胃黏膜活检标本中Hp和真菌感染的有效方法,检测方便、快捷,对于胃部疾病的诊断具有重要意义。

Background: Helicobacter pylori (Hp) infection is a major risk factor for development of gastric cancer. Some studies demonstrated a high fungal infection rate in gastric cancer tissues. There are many methods to diagnose Hp and fungal infections, and each has its advantages and disadvantages. Aims: To investigate the value of immunofluorescence staining for diagnosis of Hp and fungal infections in gastric mucosal biopsy specimens. Methods: A total of 450 gastric cancer patients undergoing gastroscopy from September 2019 to September 2020 at the General Hospital of Eastern Theater Command, PLA, were enrolled in this study. Gastric mucosal biopsy specimens were collected and stained with immuno-fluorescence, HE, and methylene blue, respectively, for detection of Hp infection, and stained with immunofluorescence and PAS, respectively, for detection of fungal infection. The microscopic findings and detection rate of various staining methods were analyzed and compared. Results: When stained with immunofluorescence, Hp was indicated by orange fluorescence on a dark black background, which was easily to be identified as compared with HE staining and methylene blue staining. The detection rate of immunofluorescence was superior to HE staining and equal to methylene blue staining (49.6% vs . 30.9%, P <0.05;49.6% vs . 48.4%, P >0.05). Fungi stained by immunofluorescence showed brilliant blue fluorescence, while those stained with PAS showed blurred red and were difficult to be distinguished from the red background. The detection rate of immunofluorescence staining was superior to PAS staining (31.6% vs. 20.2%, P < 0.05). Conclusions: Immunofluorescence staining is a convenient, fast and effective method for detecting Hp and fungal infections in gastric mucosal biopsy specimens, and is helpful for diagnosis of gastric diseases.