巨细胞病毒性胃炎之内镜检查新发现

Cytomegalovirus (CMV巨细胞病毒) disease is a serious complication after allogeneic（同种异体的） hematopoietic（造血的） stem cell transplantation (allo-SCT), which is widely accepted as a curative（有疗效的） therapy for advanced hematological（血液学的） malignancies（恶性肿瘤） including leukemia（白血病） and malignant lymphoma（恶性淋巴瘤） . CMV disease can involve many organs and stomach is a common target. Few reports have been published regarding endoscopic（内窥镜的） examination in diagnosing CMV gastritis（胃炎） after allo-SCT. A research team from Japan demonstrated the endoscopic findings of CMV gastritis after allo-SCT in addition to its clinical features. Their study will be published on June 21, 2010 in the World Journal of Gastroenterology.

In this study, CMV gastritis was diagnosed pathologically（病理上地） in seven patients (1.3%) with the other 108 patients serving as controls. Six of the seven patients developed positive CMV antigenemia（抗原血） , and five complained of abdominal pain（腹痛） . Development of abdominal pain preceded CMV antigenemia in four of the five patients. Endoscopic examination showed oozing (n = 2), erosion (n = 6), and redness (n = 5) in the seven patients with CMV gastritis, while the control patients showed oozing (n = 3), erosion (n = 24), and redness (n = 100). Erosion（侵蚀，腐蚀） and oozing（渗出，渗透） were more frequently documented in patients with CMV gastritis compared with the controls, and the differences were statistically significant (P = 0.0012 and 0.029, respectively). CMV inclusion bodies were documented in 12 of 14 biopsy（活组织检查） specimens obtained from erosive lesions, while they were identified in 4 of 15 biopsy specimens obtained from lesions other than erosions (P = 0.0025).

This study indicated that erosion and oozing might be useful markers for early diagnosis of CMV gastritis. Endoscopists should suspect CMV gastritis and obtain multiple biopsies whenever erosions are found in any stomach site when performing esophagogastroduodenoscopy（食管胃十二指肠颈镜检查） in patients after allo-SCT.