Helicobacter Pylori感染の病理―組織学的特徴

Pathology of Helicobacter pylori Infection: Histologic Features

要旨　Helicobacter Pylori（HP）感染胃粘膜の病理組織所見に関して，次の諸点を総説した．①HP同定のための染色法（H・E染色，ギムザ染色，鍍銀染色，酵素抗体法）：特に，H・E染色に対する工夫が必要である点を強調した．②胃粘膜に感染するらせん菌：H. felisおよびHPの球菌様形態について記述した．③HP感染胃粘膜の病理組織学的特徴：特に，低倍率でHP感染の見当をつけるために必要な形態所見と，カルノア固定法の有用性を述べた．④HP感染における腸上皮化生の意義：“HP感染に対する免疫学的適応現象としての腸上皮化生”の考え方を紹介した．⑤HP感染と胃黄色腫：胃黄色腫の成因の1つとして，HP感染，特に，HPの組織内侵入が挙げられる可能性を示した．

　Histologic features of the gastric mucosa with Helicobacter pylori (HP) infection were summarized. 1) The staining methods, including H・E, Giemsa, Warthin-Starry and immunoperoxidase, for demonstrating HP in paraffin sections were illustrated. Particular emphasis was placed on the usefulness of the H・E sequence by lengthening the hematoxylin staining period. 2) NonHP spiral bacilli colonizing the gastric mucosa, such as H. fells and G. hominis, as well as the coccoid form of HP, were described. 3) Histologic appearance of the gastric mucosa with HP infection was detailed. Applicability of Carnoy's fixative for immobilizing the surface mucous layer was emphasized. 4) The concept of intestinal metaplasia of the gastric mucosa as an immunologic adaptation phenomenon against HP infection was presented. 5) Pathologic significance of HP infection in causing gastric xanthoma was shown.