Helicobacter Pylori
Páginas: 15 (3561 palabras)
Publicado: 19 de octubre de 2011
Online Submissions: http://www.wjgnet.com/1007-9327office wjg@wjgnet.com doi:10.3748/wjg.v17.i13.1690
World J Gastroenterol 2011 April 7; 17(13): 1690-1693 ISSN 1007-9327 (print) ISSN 2219-2840 (online)
© 2011 Baishideng. All rights reserved.
REVIEW
How to assess the severity of atrophic gastritis
Yan-Cheng Dai, Zhi-Peng Tang, Ya-Li Zhang
Yan-Cheng Dai, Zhi-Peng Tang, Ya-Li Zhang,Department of Gastroenterology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China Yan-Cheng Dai, Zhi-Peng Tang, Ya-Li Zhang,The Institute of Digestive Disease Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China Author contributions: Dai YC, Tang ZP and Zhang YL contri buted equally to this paper.Supported by the Shanghai Leading Academic Discipline Project, No. J50305 Correspondence to: Zhi-Peng Tang, MD, Department of Gastroenterology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, 725 South Wanpin Road, Shanghai 200032, China. zhipengtang@sohu.com Telephone: +862164385700 Fax: +862164392310 Received: September 16, 2010 Revised: December 1, 2010Accepted: December 8, 2010 Published online: April 7, 2011 ophic gastritis. World J Gastroenterol 2011; 17(13): 16901693 Available from: URL: http://www.wjgnet.com/10079327/full/ v17/i13/1690.htm DOI: http://dx.doi.org/10.3748/wjg.v17.i13. 1690
INTRODUCTION
Atrophic gastritis (AG) is a histopathological entity that is characterized by chronic inflammation of the gastric mucosa with loss of gastricglandular cells and replacement by intestinal-type epithelium, pyloric-type glands, and fibrous tissue. Atrophy of the gastric mucosa is the endpoint of chronic processes, such as chronic gastritis associated with Helicobacter pylori (H. pylori) infection, other unidentified environmental factors, and autoimmunity directed against gastric glandular cells [1]. It has been established that peoplewith AG have a high risk for gastric cancer[2,3], and it has been reported that about 10% of the patients with moderate-severe AG will develop gastric malignancies during a mean follow-up of 7.8 years[4]. Thus, the assessment of the severity of AG may be an important challenge for the management of these patients because its features (i.e. extension of atrophy and intestinal metaplasia, andhypochlorhydria) may be considered as potential surrogate markers for the increased risk for gastric cancer. Here, we demonstrate some methods used to assess the severity of AG.
Abstract
Atrophic gastritis, is the main consequence of long-standing Helicobacter pylori infection, and is linked to the development of gastric cancer. The severity of atrophic gastritis is related to the lifetime risk ofgastric cancer development, especially in terms of its degree and extent of mucosal damage. Therefore, it is important for clinicians to assess the severity of atrophic gastritis, interfere with the disease progress, and reverse gastric mucosal atrophy. In the article, we demonstrated some methods (conventional endoscopy, modern endoscopic technology and noninvasive methods) that may help assess theseverity of atrophic gastritis and select the reasonable treatment protocols.
© 2011 Baishideng. All rights reserved.
DEFINITION AND CLASSIFICATION OF AG
Gastric mucosal atrophy is defined as the loss of appropriate glands, which occurs when glands damaged by inflammation are replaced either by connective tissue (scarring) or by glandular structures inappropriate for location (metaplasia).Most often, as in the antral mucosa, the metaplastic transformation assumes the phenotype of the glands lined by intestinal-type epithelium (IM), but in the oxyntic mucosa, it may also take the form of mucin-secreting antral glands (pseudopyloric metaplasia)[5]. Traditionally, AG can be divided into gastric body atrophy
Key words: Atrophic gastritis; Endoscopy; Pepsinogen Peer reviewer: Gerardo...
World J Gastroenterol 2011 April 7; 17(13): 1690-1693 ISSN 1007-9327 (print) ISSN 2219-2840 (online)
© 2011 Baishideng. All rights reserved.
REVIEW
How to assess the severity of atrophic gastritis
Yan-Cheng Dai, Zhi-Peng Tang, Ya-Li Zhang
Yan-Cheng Dai, Zhi-Peng Tang, Ya-Li Zhang,Department of Gastroenterology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China Yan-Cheng Dai, Zhi-Peng Tang, Ya-Li Zhang,The Institute of Digestive Disease Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China Author contributions: Dai YC, Tang ZP and Zhang YL contri buted equally to this paper.Supported by the Shanghai Leading Academic Discipline Project, No. J50305 Correspondence to: Zhi-Peng Tang, MD, Department of Gastroenterology, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, 725 South Wanpin Road, Shanghai 200032, China. zhipengtang@sohu.com Telephone: +862164385700 Fax: +862164392310 Received: September 16, 2010 Revised: December 1, 2010Accepted: December 8, 2010 Published online: April 7, 2011 ophic gastritis. World J Gastroenterol 2011; 17(13): 16901693 Available from: URL: http://www.wjgnet.com/10079327/full/ v17/i13/1690.htm DOI: http://dx.doi.org/10.3748/wjg.v17.i13. 1690
INTRODUCTION
Atrophic gastritis (AG) is a histopathological entity that is characterized by chronic inflammation of the gastric mucosa with loss of gastricglandular cells and replacement by intestinal-type epithelium, pyloric-type glands, and fibrous tissue. Atrophy of the gastric mucosa is the endpoint of chronic processes, such as chronic gastritis associated with Helicobacter pylori (H. pylori) infection, other unidentified environmental factors, and autoimmunity directed against gastric glandular cells [1]. It has been established that peoplewith AG have a high risk for gastric cancer[2,3], and it has been reported that about 10% of the patients with moderate-severe AG will develop gastric malignancies during a mean follow-up of 7.8 years[4]. Thus, the assessment of the severity of AG may be an important challenge for the management of these patients because its features (i.e. extension of atrophy and intestinal metaplasia, andhypochlorhydria) may be considered as potential surrogate markers for the increased risk for gastric cancer. Here, we demonstrate some methods used to assess the severity of AG.
Abstract
Atrophic gastritis, is the main consequence of long-standing Helicobacter pylori infection, and is linked to the development of gastric cancer. The severity of atrophic gastritis is related to the lifetime risk ofgastric cancer development, especially in terms of its degree and extent of mucosal damage. Therefore, it is important for clinicians to assess the severity of atrophic gastritis, interfere with the disease progress, and reverse gastric mucosal atrophy. In the article, we demonstrated some methods (conventional endoscopy, modern endoscopic technology and noninvasive methods) that may help assess theseverity of atrophic gastritis and select the reasonable treatment protocols.
© 2011 Baishideng. All rights reserved.
DEFINITION AND CLASSIFICATION OF AG
Gastric mucosal atrophy is defined as the loss of appropriate glands, which occurs when glands damaged by inflammation are replaced either by connective tissue (scarring) or by glandular structures inappropriate for location (metaplasia).Most often, as in the antral mucosa, the metaplastic transformation assumes the phenotype of the glands lined by intestinal-type epithelium (IM), but in the oxyntic mucosa, it may also take the form of mucin-secreting antral glands (pseudopyloric metaplasia)[5]. Traditionally, AG can be divided into gastric body atrophy
Key words: Atrophic gastritis; Endoscopy; Pepsinogen Peer reviewer: Gerardo...
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