胃と腸58巻1号

2023年01月発行

今月の主題 Non-H. pylori Helicobacter胃炎と周辺疾患 主題

NHPHの病理組織学的所見

著者： 太田浩良¹ 堀内一樹² 根岸達哉² 岩谷勇吾³ 長屋匡信⁴

所属機関： ¹信州大学医学部生体情報検査学 ²信州大学医学部附属病院臨床検査部 ³信州大学医学部先端治療内視鏡学講座 ⁴信州大学医学部附属病院内視鏡センター

ページ範囲：P.27 - P.35

要旨●胃に棲息するNHPH（Non-Helicobacter pylori Helicobacter）は慢性胃炎や胃・十二指腸潰瘍，胃MALTリンパ腫の発症に関わっている．NHPHは大型の桿菌で，corkscrew型の螺旋構造を持ち，H. pyloriとの鑑別にはGiemsa染色が有効である．また，抗H. pylori抗体を用いた免疫組織化学染色もNHPHの検索に有効である．NHPHは幽門部の感染頻度が高く，胃上皮細胞への接着を欠き，胃小窩内や胃粘膜表面の粘液ゲル層内に観察され，壁細胞内に認められることもある．NHPH感染慢性胃炎の特徴としては，幽門部優位の胃炎，胃上皮傷害像の欠如，軽度〜中等度の単核細胞浸潤，軽微な好中球浸潤，大型リンパ濾胞，胃小窩内のリンパ球の小集塊，腸上皮化生がまれである点が挙げられる．

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