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Endoscopic gastritis, serum pepsinogen assay, and Helicobacter pylori infection

View Article: PubMed Central - PubMed

ABSTRACT

Endoscopic findings of the background gastric mucosa are important in the Helicobacter pylori-seroprevalent population. It is strongly correlated not only with the risk of gastric cancer, but also with the excretion ability of gastric mucosa cells. In noninfected subjects, common endoscopic findings are regular arrangement of collecting venules, chronic superficial gastritis, and erosive gastritis. In cases of active H. pylori infection, nodularity on the antrum, hemorrhagic spots on the fundus, and thickened gastric folds are common endoscopic findings. The secreting ability of the gastric mucosa cells is usually intact in both noninfected and actively infected stomachs, and the intragastric condition becomes hyperacidic upon inflammation. Increased serum pepsinogen II concentration correlates well with active H. pylori infection, and also indicates an increased risk of diffuse-type gastric cancer. In chronic inactive H. pylori infection, metaplastic gastritis and atrophic gastritis extending from the antrum (closed-type chronic atrophic gastritis) toward the corpus (open-type chronic atrophic gastritis) are common endoscopic findings. The intragastric environment is hypoacidic and the risk of intestinal-type gastric cancer is increased in such conditions. Furthermore, there is a decrease in serum pepsinogen I concentration when the secreting ability of the gastric mucosa cells is damaged. Serologic and endoscopic changes that occur upon H. pylori infection are important findings for estimating the secreting ability of the gastric mucosa cells, and could be applied for the secondary prevention of gastric cancer.

No MeSH data available.


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Different endoscopic findings of nodular gastritis, metaplastic gastritis, and erosive gastritis. (A) Nodular gastritis. On the distal part of the antrum, multiple elevated nodules are seen without color change. The nodules are regular in size and shape. (B) Metaplastic gastritis. Intestinal metaplasia can be confused when hyperemic mucosa is augmented by whitish surrounding mucosa. The elevations are irregular in size, shape, and color. (C) Erosive gastritis. Elevated hyperemic erosions are scattered on the antrum.
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f5-kjim-2016-166: Different endoscopic findings of nodular gastritis, metaplastic gastritis, and erosive gastritis. (A) Nodular gastritis. On the distal part of the antrum, multiple elevated nodules are seen without color change. The nodules are regular in size and shape. (B) Metaplastic gastritis. Intestinal metaplasia can be confused when hyperemic mucosa is augmented by whitish surrounding mucosa. The elevations are irregular in size, shape, and color. (C) Erosive gastritis. Elevated hyperemic erosions are scattered on the antrum.

Mentions: Endoscopic changes due to gastric atrophy are consequences of long-term H. pylori infection which progress from lesser curvature side of the antrum to greater curvature side of the corpus. Endoscopic findings of CAG reveal the extent of gastric atrophy by showing an atrophic border consisting of visible transparent vessels (Fig. 4). Endoscopy is a reliable method with high reproducibility which was shown to predict histological atrophy in a multinational study [28]. Gastritis staging, so-called operative link on gastritis assessment (OLGA) staging, provides information on the gastric mucosa by integrating the atrophy score and topography [29]. More recently, the Kyoto Global Consensus Meeting developed a global consensus on the classification of chronic gastritis [30]. It is important to discriminate endoscopic findings based on their characteristics (Fig. 5).


Endoscopic gastritis, serum pepsinogen assay, and Helicobacter pylori infection
Different endoscopic findings of nodular gastritis, metaplastic gastritis, and erosive gastritis. (A) Nodular gastritis. On the distal part of the antrum, multiple elevated nodules are seen without color change. The nodules are regular in size and shape. (B) Metaplastic gastritis. Intestinal metaplasia can be confused when hyperemic mucosa is augmented by whitish surrounding mucosa. The elevations are irregular in size, shape, and color. (C) Erosive gastritis. Elevated hyperemic erosions are scattered on the antrum.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016293&req=5

f5-kjim-2016-166: Different endoscopic findings of nodular gastritis, metaplastic gastritis, and erosive gastritis. (A) Nodular gastritis. On the distal part of the antrum, multiple elevated nodules are seen without color change. The nodules are regular in size and shape. (B) Metaplastic gastritis. Intestinal metaplasia can be confused when hyperemic mucosa is augmented by whitish surrounding mucosa. The elevations are irregular in size, shape, and color. (C) Erosive gastritis. Elevated hyperemic erosions are scattered on the antrum.
Mentions: Endoscopic changes due to gastric atrophy are consequences of long-term H. pylori infection which progress from lesser curvature side of the antrum to greater curvature side of the corpus. Endoscopic findings of CAG reveal the extent of gastric atrophy by showing an atrophic border consisting of visible transparent vessels (Fig. 4). Endoscopy is a reliable method with high reproducibility which was shown to predict histological atrophy in a multinational study [28]. Gastritis staging, so-called operative link on gastritis assessment (OLGA) staging, provides information on the gastric mucosa by integrating the atrophy score and topography [29]. More recently, the Kyoto Global Consensus Meeting developed a global consensus on the classification of chronic gastritis [30]. It is important to discriminate endoscopic findings based on their characteristics (Fig. 5).

View Article: PubMed Central - PubMed

ABSTRACT

Endoscopic findings of the background gastric mucosa are important in the Helicobacter pylori-seroprevalent population. It is strongly correlated not only with the risk of gastric cancer, but also with the excretion ability of gastric mucosa cells. In noninfected subjects, common endoscopic findings are regular arrangement of collecting venules, chronic superficial gastritis, and erosive gastritis. In cases of active H. pylori infection, nodularity on the antrum, hemorrhagic spots on the fundus, and thickened gastric folds are common endoscopic findings. The secreting ability of the gastric mucosa cells is usually intact in both noninfected and actively infected stomachs, and the intragastric condition becomes hyperacidic upon inflammation. Increased serum pepsinogen II concentration correlates well with active H. pylori infection, and also indicates an increased risk of diffuse-type gastric cancer. In chronic inactive H. pylori infection, metaplastic gastritis and atrophic gastritis extending from the antrum (closed-type chronic atrophic gastritis) toward the corpus (open-type chronic atrophic gastritis) are common endoscopic findings. The intragastric environment is hypoacidic and the risk of intestinal-type gastric cancer is increased in such conditions. Furthermore, there is a decrease in serum pepsinogen I concentration when the secreting ability of the gastric mucosa cells is damaged. Serologic and endoscopic changes that occur upon H. pylori infection are important findings for estimating the secreting ability of the gastric mucosa cells, and could be applied for the secondary prevention of gastric cancer.

No MeSH data available.


Related in: MedlinePlus