A study on the clinicopathological characteristics of gastrointestinal sexually transmitted diseases

doi:10.3969/j.issn.1006-7795.2026.03.011

Abstract

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

CLC Number:

R365，R759

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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