胃肠道性传播疾病病原体感染的临床病理特征分析

doi:10.3969/j.issn.1006-7795.2026.03.011

首都医科大学学报 ›› 2026, Vol. 47 ›› Issue (3): 497-506.doi: 10.3969/j.issn.1006-7795.2026.03.011

胃肠道性传播疾病病原体感染的临床病理特征分析

朱美玲^1#,邱明欣^1#,洪珊²,刘菲菲³,岳闻慧¹,陈佳敏¹,程俊⁴,孙磊^1*

1.首都医科大学附属北京地坛医院病理科，北京 100015；2.首都医科大学附属北京地坛医院消化内科，北京 100015;3.广州金域医学检验中心实验诊断部/北京地坛医院-金域医学感染病理联合实验室，广州 510005; 4.深圳市人民医院病理科，广东深圳 518020

收稿日期:2026-03-05 修回日期:2026-04-23 出版日期:2026-06-21 发布日期:2026-06-26
通讯作者: 孙磊 E-mail:slpumc@126.com
基金资助:
北京市高层次公共卫生技术人才建设项目培养计划项目（学科骨干-03-21）。

A study on the clinicopathological characteristics of gastrointestinal sexually transmitted diseases

Zhu Meiling^1#, Qiu Mingxin^1#, Hong Shan², Liu Feifei³, Yue Wenhui¹, Chen Jiamin¹, Cheng Jun⁴, Sun Lei^1*

1.Department of Pathology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China; 2. Department of Gastroenterology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China; 3. Department of Clinical Laboratory, Guangzhou Kingmed Center/Ditan-KingMed Infection Pathology Laboratory, Guangzhou 510005, China; 4. Department of Pathology, Shenzhen People’s Hospital, Shenzhen 518020， Guangdong Provice, China

Received:2026-03-05 Revised:2026-04-23 Online:2026-06-21 Published:2026-06-26
Supported by:
This study was supported by the Training Program for High-level Public Health Technical Talents Construction Project (academic backbone-03-21

摘要/Abstract

摘要： 目的研究胃肠道发生的常见性传播疾病（sexually transmitted diseases，STD）相关病原体感染的临床病理特征。方法回顾性收集首都医科大学附属北京地坛医院2022年12月至2025年12月临床诊断为STD且具有胃肠道症状，并进行胃肠道病理活检的患者，收集患者临床信息及组织标本。分别进行苏木精-伊红（Hematoxylin-Eosin ,HE）染色、特殊染色、免疫组化、原位杂交及基于探针捕获的病理样本病原宏基因组检测（metagenomics capture on pathology, MetaPath）。分析胃肠道活检标本的病理形态特征。结果本研究共纳入患者19例，其中男性18例，年龄区间在23~56岁，以青壮年为主；合并人类免疫缺陷病毒（human immunodeficiency virus，HIV）感染14例（74%）；取材部位包括直肠10例（53%），肛瘘手术标本8例（42%），胃窦1例（5%）；MetaPath检测确诊组织梅毒螺旋体感染6例（32%），沙眼衣原体感染8例（42%），其他感染4例（21%），检测阴性1例（5%）。胃肠道梅毒感染的病理组织学表现为慢性活动性炎伴溃疡形成，间质内以淋巴细胞、浆细胞、中性粒细胞为主的混合性炎症细胞浸润，有中性粒细胞性血管炎；肛瘘标本梅毒感染表现为表皮上皮脚下延，伴中性粒细胞浸润，真皮层大量浆细胞、淋巴细胞浸润，梅毒螺旋体主要位于表皮近基底层细胞间隙内；胃肠道沙眼衣原体感染的病理组织学表现为黏膜溃疡、坏死，溃疡周围有明显的以淋巴细胞、浆细胞、中性粒细胞为主的混合性炎症细胞浸润。结论本研究描述性分析胃肠道性传播疾病的病理组织学特征，病理诊断炎症性肠病治疗不佳时应考虑此鉴别诊断。

关键词: 消化道, 性传播疾病, 梅毒, 沙眼衣原体, 人类免疫缺陷病毒, 病理学, 宏基因组

Abstract: Objective To investigate the clinicopathological features of common sexually transmitted diseases (STD) in the gastrointestinal tract. Methods We retrospectively collected patients with a clinical diagnosis of the common STD, presented with gastrointestinal symptoms, and had undergone a pathological biopsy, from Beijing Ditan Hospital, Capital Medical University, from December 2022 to December 2025. Clinical data and tissue specimens were collected from enrolled patients. To analyze the histopathological characteristics, gastrointestinal biopsy specimens were examined with a series of techniques, including HE staining, special staining, immunohistochemistry (IHC), in situ hybridization (ISH) and probe capture-based pathogen metagenomic testing of pathological specimens (MetaPath). Results A total of 19 patients were enrolled in this study, including 18 male, with an age range of 23 to 56 years, predominantly young and middle-aged adults. Co-infection human immunodeficiency virus (HIV) was 14 cases (74%). Biopsy sites included rectum, 10 cases (53%); anal fistula, 8 cases (42%); gastric antrum, 1 case (5%). MetaPath testing revealed infections with Treponema pallidum (TP) in 6 cases (32%), Chlamydia trachomatis (CT) in 8 cases (42%), and other pathogens in 4 cases (21%). One case (5%) tested negative. Histopathologically, gastrointestinal TP infection showed active chronic inflammation with ulceration. The inflammatory infiltrate in the stroma was mixed, predominantly composed of lymphocytes, plasma cells, and neutrophils, accompanied by neutrophilic vasculitis. In anal fistula specimens, TP infection showed elongation of the rete ridges with neutrophilic infiltration. The dermis showed a dense infiltrate of plasma cells and lymphocytes. TP was predominantly located within the intercellular spaces of the epidermal basal layer. Gastrointestinal CT infection showed mucosal ulceration and necrosis. The area around the ulcer showed a prominent mixed inflammatory infiltrate, dominated by lymphocytes, plasma cells, and neutrophils. Conclusion This study describes the histopathological features of gastrointestinal sexually transmitted diseases. This differential diagnosis should be considered in patients with pathologically diagnosed inflammatory bowel disease who show a suboptimal response to treatment.

Key words: gastrointestinal tract, sexually transmitted disease, Treponema pallidum, Chlamydia trachomatis, human immunodeficiency virus, pathology, metagenomics

中图分类号:

R365，R759

朱美玲, 邱明欣, 洪珊, 刘菲菲, 岳闻慧, 陈佳敏, 程俊, 孙磊. 胃肠道性传播疾病病原体感染的临床病理特征分析[J]. 首都医科大学学报, 2026, 47(3): 497-506.

Zhu Meiling, Qiu Mingxin, Hong Shan, Liu Feifei, Yue Wenhui, Chen Jiamin, Cheng Jun, Sun Lei. A study on the clinicopathological characteristics of gastrointestinal sexually transmitted diseases[J]. Journal of Capital Medical University, 2026, 47(3): 497-506.

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胃肠道性传播疾病病原体感染的临床病理特征分析

A study on the clinicopathological characteristics of gastrointestinal sexually transmitted diseases

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