Abstract
Objectives: To assess the diagnostic value of endoscopical findings compared to histopathological diagnosis, to delineate the relative frequency and pattern of different types of gastritis and their association with H. pylori and intestinal metaplasia in our locality, and to compare the results of this study with those of others. Methods: In a cross sectional study 150 selected patients with different upper gastrointestinal symptoms have been examined at endoscopy units in Ibn-Sina teaching hospital and Al-Jamhori teaching hospital in Mosul city, from the first of June 2013 to the first of March 2014, all were assessed endoscopically and biopsies from both antral and body mucosa were taken for histopathological examination. Results: This study has revealed gastritis histopathologically in 96.6% of cases, and the agreement between endoscopical and histophathological diagnosis was 88%. The chronic superficial gastritis represented the highest relative frequency in this histopathologically diagnosed gastritis, where it was seen in 61.3% of the cases and it’s relative frequency decreased with advance age, while chronic atrophic gastritis was diagnosed in 30% of the cases and it’s relative frequency increased with advanced age, while gastric atrophy wasn’t detected in any case. Acute gastritis was detected in only 5.3% of the cases. Helicobacter pylori was detected in 67% of cases. A significant association was detected between chronic gastritis and Helicobacter pylori infection, and its frequency decreased with increased severity of glandular atrophy. Follicular gastritis was diagnosed in 51% of chronic atrophic gastritis and 91.3% of them were Helicobacter pylori positive cases. By the use of the special stain AB/PAS pH (2.5), intestinal metaplasia has been diagnosed in 23% of cases and it’s relative frequency increased with advanced age. Conclusion: There is a high rate of concordance (88%) between endoscopical findings and histopathological diagnosis of gastritis. Among gastritis chronic variety was the commonest. H. pylori had a significant association with chronic gastritis (chronic superficial gastritis and chronic atrophic gastritis). Intestinal metaplasia has been detected mainly in chronic atrophic gastritis and its frequency increased with advanced age.
Highlights
The term gastritis has a broad histopathological and topographical spectrum lead to different concepts of what gastritis is. 1 Some think of it as a symptom complex, while others as a description of the endoscopic appearance of the stomach, it is best defined in histopathogical arm as an acute (AG) or chronic inflammation of the gastric mucosa
This study aims to assess the diagnostic value of endoscopical findings compared to histopathological diagnosis, to delineate the relative frequency and pattern of
The current study showed that the highest relative frequency of intestinal metaplasia (IM) 32 (94%) was found in chronic atrophic gastritis (CAG), while only 2 (6%) of cases with IM was found in chronic superficial gastritis (CSG)
Summary
The term gastritis has a broad histopathological and topographical spectrum lead to different concepts of what gastritis is. 1 Some think of it as a symptom complex, while others as a description of the endoscopic appearance of the stomach, it is best defined in histopathogical arm as an acute (AG) or chronic inflammation of the gastric mucosa. 1 Some think of it as a symptom complex, while others as a description of the endoscopic appearance of the stomach, it is best defined in histopathogical arm as an acute (AG) or chronic inflammation of the gastric mucosa. Chronic gastritis (CG) is distinguishable into three main categories, i.e. chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG) and gastric atrophy (GA).[2] There are several etiological types of gastritis, their different etiology being related to different clinical manifestation and pathological features.[3, 4] H. pylori has been established as a major etiological factor in the pathogenesis of chronic gastritis and gastric atrophy.[5]. An accurate diagnosis of inflammation of the stomach, can rarely be made clinically, or even on direct visualization through a gastroscope of fiberopitc tube, but it is only reliable when histopathology is available. This study aims to assess the diagnostic value of endoscopical findings compared to histopathological diagnosis, to delineate the relative frequency and pattern of
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