MODIFICÃRILE HISTOPATOLOGICE ȘI IMUNOHISTOCHIMICE DIN MUCOASA GASTRICÃ COLONIZATÃ DE HELICOBACTER PYLORI

Abstract

Helicobacter pylori (H. pylori)
colonize gastric mucosa causing both inflammatory changes, premalignant lesions and malignant
tumors, including gastric lymphoma and carcinoma. In this study, our propose was to
evaluate the histopatological changes corellated with immunohistochemical results demonstrating
the types of cellular infiltration and proliferative activity of gastric mucosa infected with H.
pylori. Material and method: Gastric endoscopic examinations was performed in 468 patients
with anti-H. pylori antibodies and dispeptic phenomena. Snippets harvested endobiopsic
stomach were fixed in formalin and processed by paraffine inclusion. Histological sections
were stained with hematoxylin-eosine and Giemsa. In 65 cases of endobiopsic fragments (36
deep chronic gastritis with intestinal metaplasia, glandular atrophy and intraepithelial neoplasia
and 29 carcinomas) immunohistochemical reactions were performed by applying reagents for
evidence of H. pylori colonies, of T lymphocytes (CD3) and macrophages (CD68) and Ki-67
reagent for proliferating nuclear antigen labelling. Results: Endobiopsic specimen found in all
H. pylori or by Giemsa staining or by anti-H. pylori antibodies when they were in small
numbers. Histologically, were diagnosed: 463 superficial and deep chronic gastritis associated
with premalignant lesions, 29 carcinomas, 2 non-Hodgkins lymphoma and an adematous
polyp. Immunohistochemically, inflammatory infiltrate consisted of numerous T lymphocytes,
macrophages and lymphoid follicles. Foveolar cell nuclei, in areas of intraepithelial neoplasia
and carcinomatous cells were intensely stained with Ki-67, demonstranting increased proliferation.
Conclusions: In gastric infection with H. pylori, inflammatory infiltrat is composed of
abundant macrophages and T lymphocytes. Ki-67 was absent or minimal in chronic gastritis,
while in areas of intraepithelial neoplasia was positive in both foveolar and coating epithelium.
Anti-H. pylori antibodies in human serum remains one of the simplest methods to detect H.
pylori, therefore it plays an important role in practice. Medical eradication of bacteria may
cancel inflammatory changes, metaplasia and proliferation of gastric mucosa and thus it
prevents the cascade of carcinogenesis.