Specificities of morphological changes in gastric mucosa in children depending on Helicobacter pylori and Epstein-Barr virus infections
The objective. To establish specificities of morphological changes of mucous membranes of the fundic and antral sections of the stomach in children depending on Helicobacter pylori (H.p.) infection and Epstein-Barr virus infection. Patients and methods. 145 children aged 10.1 ± 0.3 years with diseases of the upper digestive tract. At fibroesophago-gastroduodenoscopy (FEGDS), target biopsy of mucous membrane (MM) of the fundic and antral sections of the stomach was performed with further morphological examination and application of the bacterioscopic method of diagnosing H.p. infection. In FEGDS, express test for diagnosing H.p. infection was performed by determining urease activity of H.p. in biopsy specimens. In biopsy specimens of MM of the fundic and antral sections of the stomach, H.p. DNA was detected by PCR method. In all patients, Epstein-Barr virus (EBV) DNA was tested in gastric mucosa and blood cells by PCR method. Результаты. H.p. DNA in gastric mucosa (H.p.+) was found in 65 patients of 145 (44.8%), EBV DNA (EBV+) - in 76 patients (52.4%). The combination of H.p.+/EBV+ was determined in 41 patients (28.3%), H.p.+/EBV----in 24 patients (16.6%), H.p.-/EBV+ - in 35 patients (24.1%), H.p.-/EBV- in 45 (31.0%) children. The most marked morphological changes of MM of both the fundus and antrum were found in combined H.p.+/EBV+ infection. In the fundal part, severe dystrophy of the surface epithelium of MM in H.p.+/EBV+ infection is found in 85.4% of cases, in H.p.-/EBV- 22.2% (p < 0.001), a significant increase of the amounts of IEL is detected in H.p.+/EBV+ in 85.4% of cases, in H.p.-/EBV- in 22.2% (p < 0.001), diffuse infiltration of the lamina propria in H.p.+/EBV+ infection is found in 58.5% of cases, in H.p.-/EBV- in 2.2% (p < 0.001), lymphofollicular hyperplasia is detected in H.p.+/EBV+ in 51.2% of cases, in H.p.-/EBV- in 11.1% (p < 0.001). In the antral part, marked dystrophy of the surface epithelium of MM in H.p.+/EBV+ infection is found in 46.3% of cases, in H.p.-/EBV- in 11.1% (p < 0,001), a significant increase of the amounts of IEL is detected in H.p.+/EBV+ in 100.0% of cases, in H.p.-/EBV- in 51.1% (p < 0.001), diffuse infiltration of the lamina propria in H.p.+/EBV+ infection is found in 92.7% of cases, in H.p.-/EBV- in 33.3% (p < 0.001), lymphofollicular hyperplasia is detected in H.p.+/EBV+ in 58.5% of cases, in H.p.-/EBV- in 6.7% (p < 0.001). Conclusion. The conducted study shows that morphological changes in gastric mucosa, reflecting the degree of impairment of the organ microstructure in fundic and antral parts are significantly more frequently found in both H.p. infection, and in EBV infection. Most often, they are found in combination H.p.+/EBV+.