Histopathological features of mucosa atrophy in atrophic body gastritis

Alfredo J A Barbosa,Hulie M Ferreira,Marcela S Boldt,Carolinne B Rodrigues,Camila S C Silva,Rivelle D Pereira

doi:10.5935/1676-2444.20160006

Alfredo J A Barbosa, Hulie M Ferreira + Show 4 more

Open Access

https://doi.org/10.5935/1676-2444.20160006

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Abstract

Introduction: Gastric mucosa atrophy became a major issue in gastric pathology because of its connection with risk lesions for gastric cancer. Although gastric atrophy is frequently associated with different diseases, it has been included in many studies simply as a generic pathological condition, and different causes of gastric atrophy are omitted. Objective: To study the histopathological features of gastric mucosa atrophy inH. pylori- negative patients with atrophic body gastritis (ABG). Material and methods: Consecutive cases of patients diagnosed with ABG, and presenting normal or just lightly inflamed antral mucosa, were studied. Patients with gastrointestinal cancer and those with history of prior gastrointestinal surgery were excluded. The presence of intestinal metaplasia and pseudoantral (PSA) metaplasia in atrophic body mucosa was assessed. Results: During the period of 2004-2006 a total of 7,309 patients underwent gastroesophageal endoscopy with biopsies of the gastric mucosa; 3,556 (48.6%) were males, and 3,713 (51.4%) females. Among them, 105 had the diagnosis of ABG confirmed, with 32 (30.5%) males, and 73 (69.5%) females (p < 0.001). Intestinal metaplasia and/or PSA metaplasia were identified in all patients. As isolated lesions, PSA metaplasia was more frequent than intestinal metaplasia, respectively 42 (40%) vs. four (3.8%) cases. In most patients (56.2%) both types of metaplasia occurred simultaneously, and no differences were observed among genders (p = 0.67). Conclusion: Gastric mucosa atrophy in ABG shows distinctive histopathological features which should be considered in studies on the relationship between gastric mucosa atrophy and gastric cancer.

Highlights

Gastric mucosa atrophy became a major issue in gastric pathology because of its connection with risk lesions for gastric cancer
Among the 105 patients with atrophic body gastritis (ABG), the prevalence of women was more than two times higher than that of men, respectively 69.5% vs. 30.5% (Table 1)
PSA metaplasia was more frequently seen than intestinal metaplasia, respectively 42 (40%) vs. four (3.8%) cases

Summary

Introduction

Gastric mucosa atrophy became a major issue in gastric pathology because of its connection with risk lesions for gastric cancer. Objective: To study the histopathological features of gastric mucosa atrophy in H. pylori-negative patients with atrophic body gastritis (ABG). Gastric mucosa atrophy has become a major issue in the chapter of gastrointestinal pathology in view of its close connection with risk lesions for gastric cancer[1,2,3,4,5,6]. Endoscopic observation of the gastrointestinal mucosa has become complemented by the histopathologic analysis of mucosal fragments removed during endoscopic procedures Histological examination of these tissue specimens became a very useful tool for the final completion of the gastrointestinal endoscopy. The diagnosis of gastric atrophy and intestinal metaplasia, both of them considered risk factors for gastric cancer, has always been a source of concern as a result of the histopathological examination of endoscopic biopsies. This is true in relation to histopathology as well as in relation to conventional endoscopic evaluation; severe atrophy of the gastric mucosa can be very recognized by histology, and with significant frequency by conventional endoscopy[11]

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