具有突出的乙酸细胞的胃活检:临床病理特征和治疗反应
Nigar Anjuman Khurram1, Sanjay Kakar2, Dana Balitzer2
1Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Histopathology
|September 3, 2025
概括
拟议的组织性胃炎的标准可能错过了显著的病例. 许多胃乙酸细胞增加的患者有非特异性症状,有些人患有类固醇依赖性疾病.
科学领域:
- 胃肠病学
- 病理学
- 免疫学
背景情况:
- 在胃活检中,根据高功率场 (HPF) 的特定乙酸细胞计数来定义基因型乙酸性胃炎 (EoG),不包括已知乙酸性胃炎的病例.
- 建议的EoG标准的临床效用和诊断准确性需要进一步评估.
研究的目的:
- 评估符合组织学性胃炎标准的患者的临床表现和病理特征.
- 评估EoG的诊断标准的有效性.
主要方法:
- 在23年内对胃活检进行回顾,以确定突出的粘膜菌细胞.
- 对临床信息,内镜检查结果和医疗记录中的随访数据进行分析.
- 将病例分类为符合EoG标准的病例,具有突出异黄素但不符合标准的病例,以及具有异黄素二次原因的病例.
主要成果:
- 在87例合格病例中,56例符合EoG标准 (第一组),16例具有突出的乙蛋白,但不符合标准 (第二组). 在临床表现,内镜检测结果或治疗反应方面没有发现这些组之间的显著差异.
- 乙酸性肠炎的次要原因包括克罗恩病,Helicobacter pylori感染,强性肠炎,酸性肠炎,自身免疫性缩性肠炎和全身性肠炎.
- 在接受类固醇治疗的10名EoG患者中,有7人有反应,而3人没有反应. 两名患者出现了复发性类固醇依赖性疾病.
结论:
- 已确定的EoG标准可能不涵盖所有临床上显著的胃性病例.
- 胃粘膜中异位素的增加通常伴有非特异性胃肠道症状和内镜检测结果.
- 虽然许多患者通过保守的治疗得到改善,但部分患者可能会患上慢性类固醇依赖性疾病,需要密切监测.
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