Su-Nan Wang,1,* Yang-Kun Wang,2,* Ping Li,3 Ling-Chao Kong,4 Wei-Yi Deng,5 Bo Jiang,6 Ying-Ying Li1 

1Shenzhen Polytechnic University, Shenzhen, 518055, People’s Republic of China; 2Department of Pathology, The Fourth People’s Hospital of Longgang District, Shenzhen, 518123, People’s Republic of China; 3Department of Pathology, Peking University Shenzhen Hospital, Shenzhen, 518083, People’s Republic of China; 4Department of Pathology, Shenzhen Bao’an District Central Hospital, Shenzhen, 518102, People’s Republic of China; 5Department of Pathology, Southern Medical University Shenzhen Hospital, Shenzhen, 518100, People’s Republic of China; 6Department of Pathology, No. 990 hospital of the PLA Joint Logistics Support Force, Zhumadian, 463000, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ying-Ying Li, Email liyingyingdr@163.com

Objective: To investigate immune cell crisis and excess histopathological features during the development and progression of H. pylori infection in the gastric mucosa.
Methods: One thousand two hundred and seventy-six cases of H. pylori infection were examined by endoscopic biopsy and endoscopic submucosal dissection (ESD) resection. The relationship between epithelial cells and immune cells and the pathological features of immune cell dysfunction and excess tissue were observed. The 1276 cases of mucosal biopsy of H. pylori infection and ESD resection were included. Among them, 39 were ESD excision and 1237 were gastric mucosal biopsy specimens. Among them, there were 896 cases of antrum infection, 274 cases of stomach body infection, and 106 cases of infection in antrum and body of stomach. Three to five pieces of mucosal tissue were extracted from each site. There were 789 males (61.8%) and 454 females (35.6%). There were 724 cases (56.7%) with age ≤ 60 and 552 cases (43.3%) with age > 60.
Results: During the occurrence and development of H. pylori infection, there were not only spider-like vacuolar degeneration of surface epithelial cells, compensatory cervical mucous cell proliferation, proliferation disorder of stem cells in proliferating areas, and neoplastic proliferation of gastric mucosal epithelial cells, but also morphological changes of immune cells in the process of occurrence and development of H. pylori infection. First, neutrophils that rapidly respond and attack the infection; however, neutrophils quickly display functional deficiencies, forming mucosal erosion and micro-abscesses. Then, it enters a phase of immune cell crisis. The immune defense is adjusted. The rapid proliferation of lymphocytes leads to the formation of lymphocyte immunity and the formation of lymphocyte follicle-like structures. In this stage, the lesions are wide and deep, the duration is long, and the number of patients is large. Persistent H. pylori infection can result in abnormal proliferation and transformation of gastric mucosal epithelial cells and immune cells and gastric adenocarcinoma and MALT lymphoma.
Conclusion: Understanding the immune cell crisis and excess histopathological features during the occurrence and development of H. pylori infection is important for controlling the occurrence and development of gastric cancer and lymphoid system tumors via immune intervention.

Keywords: Helicobacter pylori, epithelial cells, immune cells, immunohistochemistry