Morphological Features of Changes in Gastric Mucosa in Patients with Chronic Atrophic Gastritis
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Keywords

chronic atrophic multifocal gastritis
chronic autoimmune gastritis
morphological examination
gastric mucosa

Abstract

Atrophic gastritis does not produce any pathognomonic signs over a long period of time and therefore, the diagnosis of chronic atrophic gastritis is mainly morphological. The main method of diagnostics of atrophic gastritis is endoscopic examination with further targeted multiple biopsy. The gastric mucosa has characteristic differences in severe and widespread atrophy, and in minor atrophic changes visually it slightly differs from superficial gastritis. Therefore, histological examination of the gastric mucosa is of decisive significance, and it is the “golden standard” of disease verification. In chronic atrophic multifocal gastritis (CAMG) atrophic changes prevailed (54.64%), and in the quarter of patients antrum was damaged. In chronic autoimmune gastritis (CAG) the foci of atrophy were mainly localized in the body of the stomach (58.63%, р<0.001), while diffuse damages (24.14%, р<0.01) and antral gastritis (6.89%, р<0.01) were rarely diagnosed. Neutrophilic infiltration of antrum MM was diagnosed in 54.64% of patients with CAMG. Moreover, the distribution according to the stages of activity was homogeneous. Total active (slight and moderate level) autoimmune gastritis was diagnosed in 62.07% of patients. The severity of the inflammatory process was characteristic for both forms of atrophic gastritis, however, in patients with CAMG monocyte-plasmatic infiltration of the lamina propria of the body and antrum, and in patients with CAG lymphocytic infiltration predominated. Atrophic alterations were diagnosed in all bioptates taken from antral part of the stomach in CAMG and body of the stomach in CAG. In CAMG there were found slight and pronounced levels of atrophy in antrum more often (39.18%, 31.95%, р<0.05), and moderately pronounced level of atrophy was more frequently found in the stomach body. Atrophy of fundal part of the stomach in first-degree and second-degree CAG was diagnosed in 41.38%, and 31.03% of patients (р1<0.05, р1<0.01).  The dependence between the activity of inflammation, density of monocyte-plasmatic infiltration and development of atrophic alterations (r=0.64, p<0.001; r=0.58, p<0.01) was found in patients with CAMG. Correlation dependence of neutrophilic-lymphocytic manifestation of inflammation (r=0.81, p<0.001) was found in the expression of the process into the stomach body.
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