Showing papers on "Chronic gastritis published in 1983"

Atrophic chronic gastritis and intestinal metaplasia in gastric carcinoma: comparison with a representative population sample

Abstract: The occurrence of chronic gastritis and intestinal metaplasia (IM) was studied in 257 patients with gastric carcinoma (GC). In all cases biopsies were available from the benign mucosal area adjacent to the tumor, and in 139 patients from the antrum and/or body mucosa outside the tumor. The results were compared with endoscopically and bioptically examined noncancer controls representing a large Finnish population sample. For every GC patient, a control subject was matched by age and sex. In addition, a mean age-adjusted score (AAS) of chronic gastritis, which expresses the progression of gastritis in GC patients as compared with that in the general population, was calculated for GC patients. The prevalences of chronic and atrophic gastritis in the antrum and body mucosa were similar in GC patients and controls when carcinoma cases were not more specifically classified according to histologic type or location of tumors. On the other hand, the location of the tumor showed a significant relation to gastritis: the progression of gastritis was more rapid (high mean AAS value) and the prevalence of atrophic gastritis was higher in the tumor-affected area (i.e., in the antrum in patients with antral [distal] tumors; in the body in patients with body [proximal] tumors), than in the general population, but were similar in the tumor-free area in both GC patients and controls. In the intestinal type of GC (IGC), the prevalence of chronic gastritis was higher and its progression was more rapid than in controls. In the diffuse type of GC (DGC), these correlations were less distinct. In GC patients, the IM adjacent to and outside the tumor area was significantly more common and extensive than in the corresponding area of controls, and a significant positive correlation was present between the location of the tumor and the distribution of IM. Like gastritis, the IM showed a closer relationship to IGC than to DGC. In all cases of GC and particularly of IGC, the antral mucosa tended to be more severely affected by gastritis and IM than the body mucosa, i.e., the prevailing type of gastritis found in this GC series was that morphologically corresponding to the so-called B-type of chronic gastritis.

The gastric mucosa in stomachs with polyps: morphologic and dynamic evaluation.

Abstract: Biopsy specimens from the antral and body mucosa of 183 patients with gastric polyps (adenoma, 4; hyperplastic polyp (HP), 52; foveolar hyperplasia (FH), 49; and inflammatory polyp (IP), 78 cases) have been examined. The prevalence of gastritis in the series was compared with that in 183 age- and sex-matched controls. The dynamics (progression) of gastritis was evaluated by means of an age-adjusted gastritic score. In the HP and FH groups the prevalence and progression of body gastritis were significantly higher and more rapid (p < 0.001) while the prevalence of antral gastritis was lower (p < 0.05) and its progression less rapid (p < 0.001) than in controls. It is concluded that the pernicious anaemia type of gastritis (A-type gastritis) is closely related to gastric polyps of hyperplastic origin. The progression of this gastritis type seemed to increase in the order IP, FH, and HP. In addition, we observed an increase in the prevalence of intestinal metaplasia (p < 0.001) and marked epithelial dysplasia...

Dyspepsia and chronic gastritis.

Abstract: The histological pattern of fundic and antral mucosa was evaluated in endoscopically bioptic material obtained from 32 dyspeptic patients in the absence of circumscribed lesions of the stomach, duodenum, hepato-biliary area and pancreas, and in 30 asymptomatic controls. The data obtained failed to reveal any significant differences between the dyspeptic patients and the asymptomatic control group as regards the presence of chronic inflammatory alterations of the fundic or antral mucosa. Furthermore, the present findings reconfirmed the well-known progression with age, of the gastric inflammatory damage both in the antral and fundic area in the two groups considered without evidence of significant differences between them. Therefore, in conclusion dyspepsia "sine materia" does not have a histological pattern of chronic gastritis either of the fundus or of the antrum as its substrate.

Is mild gastric epithelial dysplasia an indication for follow-up?

Abstract: We evaluated the changes over 1-55 months in mild gastric epithelial dysplasia (a relatively frequent, but not widely studied histological lesion) in 20 patients (11 with benign gastric ulcer, eight with chronic gastritis, and one after Billroth 2 operation), in order to ascertain whether to follow-up such patients in the future. Regression of the lesion was documented in 13 (65%), and no change in six (30%). Progression from mild to moderate dysplasia occurred in only one patient (5%). As mild dysplasia regresses or remains unchanged in most patients, at least over the short-term, specific follow-up is probably unnecessary. Nevertheless, a rational program of monitoring the associated precancerous conditions is in order.

Bile reflux and degree of gastritis after highly selective vagotomy, truncal vagotomy, and partial gastrectomy for duodenal ulcer

Abstract: Enterogastric reflux of bile has been shown to be associated with chronic gastritis. We have investigated preoperative duodenal ulcer patients and patients treated by highly selective vagotomy, Polya partial gastrectomy, truncal vagotomy and pyloroplasty, and truncal vagotomy and gastrojejunostomy to assess the incidence of endoscopically observed bile reflux and gastritis, and to quantitate the degree of reflux of bile acids and histologically proven gastritis. The correlation between observed and proven gastritis was poor when the observed incidence of bile reflux was low (preoperative duodenal ulcer, highly selective vagotomy) but was good when the observed reflux was high (partial gastrectomy, truncal vagotomy, and drainage). Bile acid concentrations in the stomach were significantly lower after highly selective vagotomy than in preoperative patients and those treated by partial gastrectomy and truncal vagotomy and drainage. The antritis and body gastritis found before operation did not improve after highly selective vagotomy, but antritis showed a tendency to worsen after partial gastrectomy and truncal vagotomy and drainage. Body gastritis after highly selective vagotomy was significantly less (P < 0.001) than after partial gastrectomy and less than after truncal vagotomy and gastrojejunostomy and truncal vagotomy and pyloroplasty. The beneficial effects of highly selective vagotomy in the treatment of duodenal ulcer may be enhanced in the long term by reduction of enterogastric reflux and postoperative gastritis.

Immunoreactive carcinoembryonic antigen in gastric juice in patients with gastric cancer

Abstract: To clarify the significance of immunoreactive carcinoembryonic antigen in gastric juice (gastric CEA) from gastric cancer patients, we studied the gastric CEA in comparison with cancer progress, histologic types of tumors, staining, for CEA and extent of intestinal metaplasia. The gastric CEA levels from patients with other gastric diseases, i.e., gastric ulcer, duodenal ulcer and chronic gastritis were also investigated. The mean gastric CEA level from gastric cancer patients was significantly higher than from gastric or duodenal ulcer patients, but there was no significant difference between levels in patients with gastric cancer and in those with chronic gastritis. The gastric CEA levels from cancer patients increased with progression of the cancer. The differentiated carcinomas showed significantly higher gastric CEA levels than the poorly differentiated carcinomas. Positive CEA tumors showed significantly higher gastric CEA levels than did the negative CEA tumors. The tumors with diffuse intestinal metaplasia revealed high gastric CEA levels. Determination of gastric CEA levels is considered to be useful for screening of gastric cancer.

[Autoimmunity factor in chronic gastritis: incidence of antiparietal cell antibodies and their relation to antral histology and basal blood gastrins]

Abstract: In 118 patients with histological proven chronic gastritis, was performed a study of seric antibodies against parietal cells (ACCP), following the indirect inmuno-fluorescence method. The results were positives in 36 cases (30%). Four positives cases were found in 40 normal controls (10%), two of them were compensated diabetics, one have the thyrohyoid Hashimoto's disease, and the remainder, brother of a patient with chronic gastritis, was a positive ACCP. A major positiveness (44.4%) was obtained in 9 cases of gastric atrophy than in 65 cases with atrophic gastritis (32%) and in 44 cases of superficial gastritis (25%); although due to the few cases of gastric atrophy regarding other histological types, conclusions cannot be obtained about the incidence of ACCP and histological variety of chronic gastritis. If we do group the patients according to their acid secretory debit, 53 achlorhydric patients had a positiveness of ACCP of 45%, while over 63 with decreased secretory capability, only 18.4%, was positive. The distribution by age groups, shows a major incidence of ACCP about the 4th and 5th decade of life. Thirty seven patients with chronic atrophic gastritis and achlorhydria, and seven with chronic superficial gastritis and hypochlorhydria, besides the antibodies study were on a basal dosage of gastrinemia and antral endoscopic biopsy, finding out that, achlorhydric patients (15 on 19) with normal or slightly altered antrus, have gastrinemia (222 +/- 123 Pgo/oo) and the majority of patients with normal gastrinemia (32 +/- 16 pgo/oo) have more important antral lesions. The ratio between antral histology and ACCP in auto--immune gastritis (Type A), conciliates only partially with the observation by Strickland et al., as only 52.4% of achlorhydric patients and ACCP have a normal antrus or al least with mild lesions. Our results suggest the possibility of that on auto--immune gastritis could act other pathogenic factors of antral lesion.

Therapeutic effects of cetraxate against acute gastritis and acute aggravation of chronic gastritis. Endoscopic investigation by the double-blind method.

Abstract: To determine the efficacy of cetraxate against acute gastritis and acute aggravation of chronic gastritis, a comparison was made with aldioxa as the standard drug by the double-blind method based mainly on observations by gastroscopy. There were four types of gastroscopic findings used: hemorrhage, erosion, redness and edema. Observations were performed whenever possible before and 1, 2 and 4 weeks after administration, and the cure and improvement rates were investigated. The cure rates for each finding except edema after 1 and 2 weeks were better (in the order of redness, erosion and hemorrhages) in the cetraxate group than in the aldioxa group, and there was a significant difference for redness in the 1st week (p less than 0.05). The no change and aggravating rates were also lower for redness in the 1st week (p less than 0.05) and edema in the 1st week (p less than 0.10) in the cetraxate group than in the aldioxa group. There were almost no differences in the effects of both drugs on subjective symptoms. The safety based on type and incidence of side effects was considered to be high for both drugs. From these results, it appeared that cetraxate is effective against acute gastritis and acute aggravation of chronic gastritis.

Stomach: Non-neoplastic Polypoidal Lesions

Abstract: Regenerative polyps are associated with chronic gastritis and have already been described (page 42) and illustrated (see Figure 6.14). Other non-neoplastic lesions can be hamartomatous, familial or both; they are uncommon but can cause confusion in biopsies and merit description.

Stomach: Gastritis and Peptic Ulceration

Abstract: Inflammatory change in gastric mucosa — as evidenced by the presence of polymorphs or by an increase in number of lymphocytes, plasma cells, mast cells or eosinophils — is a histological finding which by no means always corresponds with a history of dyspepsia, and in people over the age of 60 is so common that many pathologists and clinicians regard it as ‘normal’. This cellular infiltration results from mucosal contact with irritants which include refluxed bile acid, alcohol, drugs and poisons and also from auto-immune type reactions, and, if the irritant is continuous or the mucosal defences alter, can be followed by epithelial erosion, ulceration and atrophy with loss of gland elements. These changes are initially reversible but become less so as they become more severe and long-continued. It is not uncommon for gastric mucosa so affected to undergo metaplasia to an intestinal pattern, which can eventually become dysplastic with an increased risk of carcinomatous change. It is therefore important to classify accurately the different patterns of gastritis, always relating the findings to the age of the patient.