The Significance Of Duodenal Eosinophils And Chromogranin A-positive Cells In Patients With Functional Dyspepsia

Objective : To compare the significance of duodenal eosinophils(EOS) and chromogranin A(Cg A)-positive cells in patients with functional dyspepsia(FD). Method:FD and FD overlap diarrhea-predominant irritable bowel syndrome(FD+IBS-D) outpatients who fulfilled Rome III criteria accepted a questionnaire of symptoms and SF-36.The mucosal biopsies was collected from front wall of duodenal bulb during gastroscopy, and the mucosal EOS were detected by HE staining, and the Cg A by immunostaining. EOS and Cg A cells were quantified by counting the numbers per 5 high-power field and per 3 high-power field. Then the correlation between the number of EOS、Cg A-positive cells and the symptoms were analyzed respectively.Results: A total of twenty-eight FD patients and twelve FD+IBS-D patients were included in the study. The ratio of male to female in FD was 10/18, with the mean age of 41.00±9.75 y, and 14(50.0%) patients had HP infection. The same items in FD overlap IBS-D patients were 4/8、42.50±8.06 y and 33.33%, respectively. The scales of social function and mental health by SF-36 were significantly more severe in FD+IBS-D than in FD(P < 0.05). The number of duodenal bulb EOS in FD+IBS-D group(32.48±9.31/mm2)were significantly higher than FD group(22.84±4.84/mm2,P=0.002), while the number of duodenal bulb Cg A-positive cells in FD+IBS-D group(13.03±5.87/HPF)were significantly lower than FD group(19.85±9.18/mm2,P=0.023).There was a positive relationship between the duodenal EOS numbers and the degree of abdominal pain/discomfort(lower digestive tract)(r=0.561,P=0.000) 、diarrhea(r=0.664,P=0.000)、mucous stool(r=0.492,P=0.001)、or defecating unfinished feeling(r=0.595,P=0.000) respectively, while a negative correlation between the EOS numbers and belching(r=-0.459,P=0.003). However, there was not a correlation neither between EOS and SF-36, nor between Cg A and symptoms. Duodenal Cg A have a positive correlation with social function of SF-36(r=0.323,P=0.042), whereas there was not a correlation between the rest of dimemsions and Cg A.Conclusion:(1) The duodenal bulb EOS were higher while Cg A-positive cells were lower in patients with FD overlaping IBS-D than those with FD, which may implicate the difference of symptoms in gastrointestinal disease.(2) The scales of social function and mental health in SF-36 were significantly more severe in FD overlapping IBS-D than FD, suggesting gastrointestinal symptoms and psychological status influence each other.