Endocrine cell growths in atrophic body gastritis. Critical evaluation of a histological classification

Abstract

The aim of the present study was to evaluate the correspondence of the classification of non‐antral endocrine cell growths proposed by Solcia and co‐workers with clinical features and non‐endocrine mucosal changes. For this purpose, 94 cases of newly diagnosed atrophic body gastritis were investigated using endoscopic biopsies and compared with 18 control subjects. The patients were subdivided into the following four groups according to the most severe pattern of endocrine cell proliferation found in the body mucosa, as shown by chromogranin A immunostaining: group 1, normal pattern (7 cases, 7·5 per cent); group 2, simple hyperplasia (6 cases, 6·5 per cent); group 3, linear hyperplasia (24 cases, 25·8 per cent); group 4; micronodular hyperplasia (56 cases, 60·2 per cent). Adenomatoid hyperplasia was found in only one case, thus precluding further analysis. Patients in groups 1 and 2 had lower acid secretion, higher gastrin level, and higher mean scores in all histopathological variables of chronic gastritis considered by the Sydney system when compared with controls, but did not differ among them in any parameter investigated. When compared with groups 1 and 2, patients of groups 3 and 4 showed higher values of circulating gastrin, higher scores of glandular atrophy, and lower values of acid secretion and of mononuclear and neutrophil inflammatory cell infiltration. Moreover, group 4 patients differed significantly from those of group 3 in their higher gastrin levels and atrophy scores, and lower scores of neutrophil cell infiltration. On the basis of these results, it is proposed that for practical purposes the normal and the simple hyperplasia patterns may be incorporated into a single group. It is concluded that this classification in its simplified form, based on a qualitative histological approach, shows clinical relevance without the need to perform expensive, time‐consuming morphometric evaluations. © 1997 John Wiley & Sons, Ltd.

Autoimmune Gastritis: Distinct Histological and Immunohistochemical Findings Before Complete Loss of Oxyntic Glands

“…The results from this study suggest that at least linear hyperplasia may be a useful marker of AG. Obviously, there must be a progression through simple hyperplasia to reach linear hyperplasia, so the findings of simple hyperplasia are not incompatible with AG and, in fact, have been previously reported (7). Nevertheless, simple hyperplasia is potentially more difficult to interpret, as this level of hyperplasia (and occasionally linear) has been reported in a small percentage of patients on PPI (13)(14)(15).…”

“…Although most cases can be classified as AG or as H. pylori infection, these two entities can certainly coexist as seen in three of the cases in this study. In the original histological description of AG with remaining oxyntic mucosa, 22.5% of patients had both AG and H. pylori infection (2), and other studies have also noted concurrent AG and H. pylori infection (7). Lymphoma of the mucosal-associated lymphoid tissue (MALT) can also occasionally be in the differential diagnosis for AG but can usually be differentiated by the dense, destructive nature of the neoplastic B-cell infiltrates in MALT lymphoma.…”

“…Periodic acid-Schiff/Alcian blue stains were also available and confirmed the presence of intestinal metaplasia. ECL cell hyperplasia in the gastric body was evaluated using chromogranin stains in 35 available cases and was scored as normal, simple, linear, or nodular hyperplasia using the modified Solcia classification schema (7,8). Briefly, simple hyperplasia showed a mild increase over normal that did not reach the level of linear hyperplasia.…”

The long‐term effects of cure of Helicobacter pylori infection on patients with atrophic body gastritis

“…The diagnosis of atrophic body gastritis was based on the pentagastrin-resistant achlorhydria or hypochlorhydria (peak acid output, < 13 mmol ⁄ h) and histological confirmation of atrophy (see ÔHistological proceduresÕ below). 3,6,20 The diagnosis of pernicious anaemia was based on the following criteria: pentagastrin-resistant achlorhydria, macrocytic anaemia, low levels of vitamin B 12 and response to vitamin B 12 therapy. 3,6 Histological procedures.…”

Effect of the somatostatin analog octreotide on gastric mucosal function and histology during 3 months of preoperative treatment in patients with acromegaly

“…The return to pre-tx concentrations at M3 after its initial suppression must be interpreted taking into consideration the elevated pH at this time. Reduced intragastric acidity is a potent stimulus to gastrin secretion (26). In the presence of an…”