Gastric intestinal metaplasia type III cases are classified as low-grade dysplasia on the basis of morphometry

1993 ◽  
Vol 169 (1) ◽  
pp. 73-78 ◽  
Author(s):  
Piero Tosi ◽  
M. Isabel Filipe ◽  
Pietro Luzi ◽  
Clelia Miracco ◽  
Rosa Santopietro ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Low Grade ◽  
Gastric Intestinal Metaplasia ◽  
Type Iii ◽  
Low Grade Dysplasia

Serum pepsinogen levels and OLGA/OLGIM staging in the assessment of atrophic gastritis types

2020 ◽  
pp. postgradmedj-2020-139183
Author(s):  
Deniz Ogutmen Koc ◽  
Sibel Bektas
Keyword(s):  
Atrophic Gastritis ◽  
Intestinal Metaplasia ◽  
Disease Stage ◽  
Low Grade ◽  
Serum Pepsinogen ◽  
Gastric Intestinal Metaplasia ◽  
Biopsy Specimens ◽  
Staging Systems ◽  
Advanced Stages ◽  
Autoimmune Atrophic Gastritis

BackgroundWe assessed the validity of using serum pepsinogen tests (sPGTs) to differentiate autoimmune atrophic gastritis (AAG) from environmental atrophic gastritis (EAG). We also investigated the correlation and prognostic value between disease stage, according to Operative Link for Gastritis Assessment (OLGA)/Operative Link on Gastric Intestinal Metaplasia Assessment (OLGIM), and sPGT results in patients with gastric atrophy.MethodsWe enroled 115 patients in this prospective study: 95 with atrophic gastritis (16 with AAG and 79 with EAG) and 20 non-atrophic gastritis. These patients, along with 32 control patients, underwent esophagogastroduodenoscopy. Atrophy and intestinal metaplasia of the gastric biopsy specimens were staged according to the OLGA/OLGIM staging systems.ResultsThe median (IQR) age of the patients (83 females (56.5%)) was 58 (46–67) years. Patients in the AAG group represented histologically advanced stages. The AAG group had lower pepsinogen (PG) I and II levels, as well as a lower PGI/PGII ratio, compared with the EAG group (p<0.01, p<0.05 and p<0.01, respectively). The optimal PGI/PGII ratio for predicting AAG was ≤1.9 (100% sensitivity and 100% specificity), and that for predicting EAG was ≤9.2 (47.5% sensitivity and 90.6% specificity). The OLGA/OLGIM stage was negatively correlated with the PGI level and PGI/PGII ratio. In the AAG group, four of five patients with low-grade dysplasia had OLGA/OLGIM stage III–IV disease.ConclusionssPGT may provide valuable information for differentiating advanced-stage AAG from EAG, and in patients with atrophic gastritis, use of sPGTs and OLGA/OLGIM staging together may predict gastric cancer risk.

scholarly journals The Prevalence of Gastric Intestinal Metaplasia and Distribution ofHelicobacter pyloriInfection, Atrophy, Dysplasia, and Cancer in Its Subtypes

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Sehmus Olmez ◽  
Mehmet Aslan ◽  
Remzi Erten ◽  
Suleyman Sayar ◽  
Irfan Bayram
Keyword(s):  
Intestinal Metaplasia ◽  
Gastric Adenocarcinoma ◽  
Cancer Development ◽  
Common Finding ◽  
Gastric Intestinal Metaplasia ◽  
Type Iii ◽  
High Prevalence ◽  
H Pylori ◽  
Clinical Records ◽  
Main Factor

Objectives. Gastric intestinal metaplasia (IM) is frequently encountered and is considered a precursor of gastric adenocarcinoma. In the Van region of Turkey, gastric adenocarcinoma incidence is high but the prevalence of gastric IM is not known.Helicobacter pylori(H. pylori) infection is a main factor leading to atrophy, IM, and cancer development in the stomach. The aim of the current study was to investigate the prevalence of IM and its subtypes and the prevalence ofH. pyloriinfection, atrophy, dysplasia, and cancer in gastric IM subtypes.Materials and Methods. This retrospective study was conducted on 560 IM among the 4050 consecutive patients who were undergoing esophagogastroduodenoscopy (EGD) with biopsy between June 2010 and October 2014. Clinical records and endoscopic and histopathologic reports of patients with IM were analyzed.Results. The prevalence of gastric IM was 13.8%. The prevalence of incomplete IM was statistically significantly higher than complete IM. Type III IM was the most frequent subtype.Conclusions. Gastric IM is a common finding in patients undergoing EGD with biopsy in this region. High prevalence of incomplete type IM, especially type III, can be associated with the high prevalence of gastric cancer in our region.

scholarly journals Polypoid Dysplasia in Barrett’s Esophagus: Diagnosis, Management, and Very Different Outcomes in Two Consecutive Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Megan Murphy ◽  
Christina Tofani ◽  
Kunjal Gandhi ◽  
Anthony Infantolino
Keyword(s):  
Intestinal Metaplasia ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Case Series ◽  
Gastric Cardia ◽  
Low Grade ◽  
Invasive Adenocarcinoma ◽  
Increased Risk ◽  
Low Grade Dysplasia ◽  
One Year

Background. Barrett’s esophagus is associated with an increased risk of adenocarcinoma. Dysplasia in Barrett’s esophagus is a precursor to adenocarcinoma. Rarely, dysplastic polypoid lesions are superimposed on Barrett’s esophagus. Most reported cases of polypoid dysplasia in Barrett’s esophagus have been advanced on presentation and treated with esophagectomy. We describe two cases of polypoid changes in Barrett’s esophagus and treatment with polypectomy followed by radiofrequency ablation.Cases. A 75 yo male presented with esophageal polyps, which on biopsy showed gastric cardia/foveolar mucosa with focal intestinal metaplasia without dysplasia. Biopsy of intervening flat mucosa was consistent with nondysplastic Barrett’s esophagus. Extensive hot snare polypectomies were performed followed by RFA. One year later, repeat EGD revealed no evidence of Barrett’s esophagus. A 61 yo male presented with esophageal polyps, which on biopsy showed gastric cardia/foveolar mucosa with intestinal metaplasia and foci of low-grade dysplasia. Extensive hot snare polypectomies were performed followed by RFA. At repeat EGD, four months later, an esophageal mass was found. Biopsy of the mass showed invasive adenocarcinoma. The patient was referred for esophagectomy.Conclusion. This case series shows two outcomes, one with successful eradication of dysplasia and the other with disease progression to invasive adenocarcinoma requiring esophagectomy.

Gastric Intestinal Metaplasia Type III and Prospective Risk of Gastric Cancer in Colombia

2017 ◽  
Vol 152 (5) ◽  
pp. S473 ◽  
Author(s):  
M. Blanca Piazuelo ◽  
M. Constanza Camargo ◽  
Robertino M. Mera ◽  
Alberto G. Delgado ◽  
Juan C. Bravo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Intestinal Metaplasia ◽  
Gastric Intestinal Metaplasia ◽  
Type Iii ◽  
Prospective Risk

scholarly journals Dose-dependent association of proton pump inhibitors use with gastric intestinal metaplasia among Helicobacter pylori-positive patients

2020 ◽  
pp. 205064062095140
Author(s):  
Yifat Snir ◽  
Haim Leibovitzh ◽  
Yaara Leibovici-Weissman ◽  
Alex Vilkin ◽  
Arnon D Cohen ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Intestinal Metaplasia ◽  
Parietal Cell ◽  
Proton Pump ◽  
Low Grade ◽  
Gastric Intestinal Metaplasia ◽  
Parietal Cell Antibodies ◽  
Dose Dependent ◽  
Inhibitor Dose

Background Gastric intestinal metaplasia is a pre-cancerous condition associated with multiple factors. Objective We evaluated whether cumulative proton pump inhibitor dose is associated with the diagnosis of gastric intestinal metaplasia while controlling for multiple variables. Methods We retrospectively identified patients who underwent upper endoscopy with gastric biopsy between 2005 and 2014. Covariate data retrieved included age, sex, ethnicity, smoking status, Helicobacter pylori status (based on clarithromycin–amoxicillin–proton pump inhibitor issued), cumulative proton pump inhibitor issued within 10 years (quartiles (PPI-Q1–4) of daily drug dose), anti-parietal cell antibodies, body mass index and comorbidity index. Results Of the 14,147 included patients (median age 63.4 years; women 54.4%; Helicobacter pylori-positive 29.0%), 1244 (8.8%) had gastric intestinal metaplasia. Increasing age, Helicobacter pylori infection, smoking, anti-parietal cell antibodies and proton pump inhibitor use were all associated with the diagnosis of gastric intestinal metaplasia. Upper quartiles of cumulative proton pump inhibitor doses (PPI-Q4 and PPI-Q3 vs. PPI-Q1) were associated with the diagnosis of gastric intestinal metaplasia: adjusted odds ratios 1.32 (95% confidence interval (CI) 1.11–1.57) and 1.27 (95% CI 1.07–1.52), respectively, for the whole cohort ( Ptotal 0.007, Ptrend 0.013), 1.69 (95% CI 1.23–2.33) and 1.40 (95% CI 1.04–1.89), respectively, for Helicobacter pylori-positive patients ( Ptotal 0.004, Ptrend 0.005) and 1.21 (95% CI 0.98–1.49) and 1.20 (95% CI 0.96–1.49), respectively, for Helicobacter pylori-negative patients ( Ptotal 0.288, Ptrend 0.018). Upper quartiles of proton pump inhibitor dose were associated with a 5–10-fold increased risk of low-grade dysplasia. Conclusions Among Helicobacter pylori-positive patients, proton pump inhibitor use appears to be associated with a dose-dependent increased likelihood of gastric intestinal metaplasia.

scholarly journals Her2/neu Protein Expression and Oncogene Amplification in Gastric Carcinoma with Clinico-Pathological Correlation in Egyptian Patients

2016 ◽  
Vol 4 (4) ◽  
pp. 535-542 ◽  
Author(s):  
Ahmed Abdel Hadi ◽  
Ali El Hindawi ◽  
Amal Hareedy ◽  
Heba Khalil ◽  
Ranya Al Ashiry ◽  
...  
Keyword(s):  
Gastric Carcinoma ◽  
Protein Expression ◽  
Intestinal Metaplasia ◽  
Gene Amplification ◽  
Target Therapy ◽  
High Grade Dysplasia ◽  
Low Grade ◽  
High Grade ◽  
Fish Technique ◽  
Low Grade Dysplasia

AIM: Amplification of the Her2/neu gene and overexpression of the Her2/neu protein in gastric carcinoma (GC) is a golden criterion for target therapy with trastuzumab (Herceptin). We aim to evaluate the immunohistochemical protein expression and amplification of the oncogene Her2/neu by FISH technique in the epithelial gastric carcinoma and to compare their association with different clinicopathologic parameters aiming at identifying positive cases that may benefit from targeted therapy.MATERIALS AND METHODS: This study was done on eighty-five tumour tissue samples from patients with GC as well as thirty non-malignant lesions (Gastritis, intestinal metaplasia, adenoma with low-grade dysplasia, adenoma with high-grade dysplasia). All were immunohistochemically stained with Her2/neu antibody.RESULTS: All equivocal and some selected GC cases were submitted for FISH technique to detect Her2/neu gene amplification. By immunohistochemistry twenty-three cases (27%) were defined as positive for Her2/neu gene amplification and/or protein overexpression. The levels of Her2/neu positive (3+), Her2/neu equivocal (2+) and Her2/neu negative (1+/0) were measurable in 14.2%, 32.9% and 52.9% of the samples, respectively. FISH showed that Her2/neu gene was amplified in 22 cases, 10 Her2/neu positive (3+), 11 (39.3%) Her2/neu equivocal (2+) and 1 Her2/neu negative (1+) cases with IHC staining those who can benefit from anti Her2/neu target therapy. Her2/neu was overexpressed positivity (3+) more in intestinal type and mixed carcinoma, and moderately differentiated tumours. None of gastritis, intestinal metaplasia or adenoma with low-grade dysplasia cases showed positivity for Her2/neu (3+). The Her2/neu positivity (3+) was associated with both adenocarcinoma cases and high-grade dysplasia (P = 0.002).CONCLUSIONS: The results highlight the necessity of FISH test for further categorization when gastric cancer cases are equivocal (2+) by IHC to determine eligibility for the targeted therapy. Stepwise increase in the expression of Her2/neu was seen in low-grade dysplasia, high-grade dysplasia and carcinoma cases implying its role in cancer evolution. Overexpression of Her 2/neu in GC patients can be promising in selecting those who can get benefit from anti-Her2/neu target therapy.

scholarly journals Prevalence of subtypes of gastric intestinal metaplasia and its relationship with Helicobacter pylori infection

2020 ◽  
Vol 10 (1) ◽  
pp. 1650-1653
Author(s):  
Sanat Chalise ◽  
Roshan Ghimire ◽  
Sailesh B. Pradhan
Keyword(s):  
Helicobacter Pylori ◽  
Intestinal Metaplasia ◽  
Alcian Blue ◽  
College Teaching ◽  
Helicobacter Pylori Infection ◽  
Type I ◽  
Gastric Intestinal Metaplasia ◽  
Type Iii ◽  
Endoscopic Biopsies ◽  
Blue Stain

Background: Gastric intestinal metaplasia is seen chronic gastritis associated with Helicobacter pylori. The objective of this study was to determine the prevalence of subtypes of intestinal metaplasia and presence of Helicobacter pylori infection. Materials and Methods: This was a cross sectional study done at Kathmandu Medical College teaching Hospital in Pathology department from December 2018 to August 2019. The endoscopic biopsies were evaluated for intestinal metaplasia and Helicobacter pylori with the help of Hematoxylin and Eosin stains as well as Giemsa stain. Subtypes of intestinal metaplasia were classified with the help of periodic acid- Schiff/Alcian Blue stain combination and High Iron Diamine- Alcian Blue stain at pH 2.5. The relationship between Helicobacter pylori and subtypes of intestinal metaplasia were compared. Fisher’s exact test was used for statistical evaluation. A p value of ˂0.05 was considered as statistically significant. Results: The prevalence of intestinal metaplasia was found in 57 (12.2%) biopsies. Type I intestinal metaplasia was found in 23 (40.4%) biopsies, type II in 10 (17.5%) biopsies and type III in 24 (42.1%) biopsies. Helicobacter pylori was positive in 28(49.1%) and it was negative in 29(50.9%) biopsies. No statistical significant correlation was seen in the subtypes of intestinal metaplasia with Helicobacter pylori status (p˃0.05). Conclusion: Intestinal metaplasia is frequently observed in endoscopic biopsies, most common being type III subtype.

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