Prevalence of intestinal metaplasia and its relation to Helicobacter pylori infection in Iraq

Objectives: The aim of this study was to investigate the prevalence of intestinal metaplasia and its relation to H. Pylori infection, gastric atrophy, ulcer, age and gender in patients underwent esophagogastroduodenoscopy and gastric biopsy for upper gastrointestinal symptoms. Method: 200 gastric biopsy blocks examined for patients underwent esophagogastroduodenoscopy (EGD) and gastric biopsy, between January 2019 October 2020 at Gastroenterology and hepatology Hospital / Medical city / Baghdad / Iraq. Result: (67.5%) of patients examined in the study had H. pylori infection, while (20.5%) of the total number patients in the study had gastric intestinal metaplasia. There was significant association between Intestinal metaplasia with both active chronic inflammation and intestinal atrophy but there was no significant association between Intestinal metaplasia with both ulcer and H. pylori infection. Conclusion: gastric intestinal metaplasia encountered more in old age male patients with gastric atrophy and it is not solely related to h pylori, other risk factors could be responsible for it.

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The Orientation of Gastric Biopsy Samples Improves the Interobserver Agreement of the OLGA Staging System

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.264.olg ◽

2017 ◽

Vol 26 (4) ◽

pp. 351-356 ◽

Cited By ~ 5

Author(s):

Bogdan Cotruta ◽

Cristian Gheorghe ◽

Razvan Iacob ◽

Mona Dumbrava ◽

Cristina Radu ◽

...

Keyword(s):

Intestinal Metaplasia ◽

Lamina Propria ◽

Case Series ◽

Gastric Biopsy ◽

Gastric Atrophy ◽

Observer Agreement ◽

Gastric Body ◽

Kappa Index ◽

Gastric Biopsies

Background & Aims: Evaluation of severity and extension of gastric atrophy and intestinal metaplasia is recommended to identify subjects with a high risk for gastric cancer. The inter-observer agreement for the assessment of gastric atrophy is reported to be low. The aim of the study was to evaluate the inter-observer agreement for the assessment of severity and extension of gastric atrophy using oriented and unoriented gastric biopsy samples. Furthermore, the quality of biopsy specimens in oriented and unoriented samples was analyzed.Methods: A total of 35 subjects with dyspeptic symptoms addressed for gastrointestinal endoscopy that agreed to enter the study were prospectively enrolled. The OLGA/OLGIM gastric biopsies protocol was used. From each subject two sets of biopsies were obtained (four from the antrum, two oriented and two unoriented, two from the gastric incisure, one oriented and one unoriented, four from the gastric body, two oriented and two unoriented). The orientation of the biopsy samples was completed using nitrocellulose filters (Endokit®, BioOptica, Milan, Italy). The samples were blindly examined by two experienced pathologists. Inter-observer agreement was evaluated using kappa statistic for inter-rater agreement. The quality of histopathology specimens taking into account the identification of lamina propria was analyzed in oriented vs. unoriented samples. The samples with detectable lamina propria mucosae were defined as good quality specimens. Categorical data was analyzed using chi-square test and a two-sided p value <0.05 was considered statistically significant.Results: A total of 350 biopsy samples were analyzed (175 oriented / 175 unoriented). The kappa index values for oriented/unoriented OLGA 0/I/II/III and IV stages have been 0.62/0.13, 0.70/0.20, 0.61/0.06, 0.62/0.46, and 0.77/0.50, respectively. For OLGIM 0/I/II/III stages the kappa index values for oriented/unoriented samples were 0.83/0.83, 0.88/0.89, 0.70/0.88 and 0.83/1, respectively. No case of OLGIM IV stage was found in the present case series. Good quality histopathology specimens were described in 95.43% of the oriented biopsy samples, and in 89.14% of the unoriented biopsy samples, respectively (p=0.0275).Conclusion: The orientation of gastric biopsies specimens improves the inter-observer agreement for the assessment of gastric atrophy.Key words: – – – .Abbreviations: H. pylori: Helicobacter pylori; OLGA: operative link for gastritis assessment; OLGIM: operative link on intestinal metaplasia assessment.

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Helicobacter Infection and Gastric Adenoma

Microorganisms ◽

10.3390/microorganisms9010108 ◽

2021 ◽

Vol 9 (1) ◽

pp. 108

Author(s):

Simone Bertz ◽

Miriam Angeloni ◽

Jan Drgac ◽

Christina Falkeis ◽

Corinna Lang-Schwarz ◽

...

Keyword(s):

Intestinal Metaplasia ◽

Clinicopathological Parameters ◽

Consecutive Series ◽

Gastric Adenoma ◽

Gastric Intestinal Metaplasia ◽

Pyloric Gland Adenoma ◽

Hereditary Tumor Syndromes ◽

Mucosal Changes ◽

H Pylori ◽

Insight Into

Background: We aimed to provide insight into the actual frequencies of gastric adenoma types and their association with gastritis status and associated mucosal changes with a focus on Helicobacter infection and the operative link on gastritis assessment (OLGA)/operative link on gastric intestinal metaplasia assessment (OLGIM) staging. Methods: From the archive of the Institute of Pathology in Bayreuth, we collected a consecutive series of 1058 gastric adenomas diagnosed between 1987 and 2017. Clinicopathological parameters retrieved from diagnostic reports included adenoma type and localization, associated mucosal changes in antrum and corpus (i.e., type of gastritis, the extent of intestinal metaplasia and atrophy), gender, date of birth, and date of diagnosis. Results: Intestinal-type adenoma was the most frequent adenoma (89.1%), followed by foveolar-type adenoma (4.3%), pyloric gland adenoma (3.4%), adenomas associated with hereditary tumor syndromes (2.8%), and oxyntic gland adenoma (0.4%). Adenomas were found in the background of Helicobacter pylori (H. pylori) gastritis in 23.9%, Ex-H. pylori gastritis in 36.0%, autoimmune gastritis in 24.8%, chemical reactive gastritis in 7.4%, and others in 0.1%. More than 70% of patients with gastric adenomas had low-risk stages in OLGA and OLGIM. Conclusions: We found a higher frequency of foveolar-type adenoma than anticipated from the literature. It needs to be questioned whether OLGA/OLGIM staging can be applied to all patients.

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Reduced apoptosis in H. pylori-associated gastric intestinal metaplasia: A factor in gastric carcinogenesis?

Gastroenterology ◽

10.1016/s0016-5085(98)82772-8 ◽

1998 ◽

Vol 114 ◽

pp. A676 ◽

Cited By ~ 2

Author(s):

IA Scotiniotis ◽

T Rokkas ◽

EE Furth ◽

JW Plotkin ◽

B Rigas ◽

...

Keyword(s):

Intestinal Metaplasia ◽

Gastric Carcinogenesis ◽

Gastric Intestinal Metaplasia ◽

H Pylori

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H. pylori and NSAIDs: a meta-analysis on interactions of acute gastroduodenal injury, gastric and duodenal ulcers and upper gastrointestinal symptoms

Helicobacter pylori ◽

10.1007/978-94-011-1418-9_42 ◽

1994 ◽

pp. 449-457 ◽

Cited By ~ 5

Author(s):

S. J. O. Veldhuyzen Van Zanten

Keyword(s):

Meta Analysis ◽

Gastrointestinal Symptoms ◽

Duodenal Ulcers ◽

Upper Gastrointestinal Symptoms ◽

H Pylori ◽

Upper Gastrointestinal

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Can neopterin be a useful immune biomarker for differentiating gastric intestinal metaplasia and gastric atrophy from non-atrophic non-metaplastic chronic gastritis?

Gastroenterología y Hepatología (English Edition) ◽

10.1016/j.gastre.2019.05.001 ◽

2019 ◽

Vol 42 (5) ◽

pp. 289-295

Author(s):

Ufuk Kutluana ◽

Ayse Guldem Kilciler ◽

Soycan Mizrak ◽

Utku Dilli

Keyword(s):

Intestinal Metaplasia ◽

Chronic Gastritis ◽

Gastric Atrophy ◽

Gastric Intestinal Metaplasia

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Host Wnt/β-catenin pathway triggered by Helicobacter pylori correlates with regression of gastric intestinal metaplasia after H. pylori eradication

Journal of Medical Microbiology ◽

10.1099/jmm.0.007310-0 ◽

2009 ◽

Vol 58 (5) ◽

pp. 567-576 ◽

Cited By ~ 18

Author(s):

Kuei-Hsiang Hung ◽

Jiunn-Jong Wu ◽

Hsiao-Bai Yang ◽

Li-Ju Su ◽

Bor-Shyang Sheu

Keyword(s):

Helicobacter Pylori ◽

Intestinal Metaplasia ◽

Glycogen Synthase ◽

Nucleotide Polymorphisms ◽

Ags Cells ◽

Gastric Intestinal Metaplasia ◽

Before And After ◽

Cox 2 ◽

H Pylori ◽

High Level

Helicobacter pylori eradication can reverse gastric intestinal metaplasia (IM) in some but not all patients. H. pylori induces high levels of nuclear β-catenin staining in IM tissues, as well as overexpression of cyclooxygenase-2 (COX-2). This study investigated whether the Wnt/β-catenin pathway plays a role in IM regression following H. pylori eradication. Sixty-five H. pylori-infected patients with IM who had achieved successful H. pylori eradication provided paired gastric samples before and after eradication to analyse the persistence of IM, and to assess COX-2 and nuclear β-catenin expression. The host genotypes of single nucleotide polymorphisms (SNPs) of the COX-2, β-catenin (CTNNB1) and adenomatous polyposis coli (APC) genes were analysed. In addition, expression of β-catenin, E-cadherin and phosphorylated and unphosphorylated glycogen synthase kinase 3β (GSK-3β) in cell lines challenged with H. pylori isolates from patients with and without IM persistence was compared by immunoanalysis. After a mean 33.9-month follow-up after H. pylori eradication, 44 patients (67.7 %) with IM persistence had a higher rate of high-level nuclear β-catenin expression in IM tissue than those without IM persistence (P=0.008). The patients with IM persistence had a higher rate of AA, GG and AA APC SNP genotypes at positions 4479, 5268 and 5465, respectively, than the patients without IM persistence (P=0.022). The H. pylori isolates from the patients with IM regression after H. pylori eradication induced more phospho-GSK-3β in AGS cells than isolates from patients with IM persistence (P=0.011). It is likely that interactions with H. pylori and the patient's Wnt/β-catenin genetic predisposition determine the outcome of IM persistence following H. pylori eradication.

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Topographic study of H. pylori and gastric intestinal metaplasia in patients with dyspepsia in a tertiary health care setting

Tropical Journal of Pathology and Microbiology ◽

10.17511/jopm.2019.i05.05 ◽

2019 ◽

Vol 5 (5) ◽

pp. 281-286

Author(s):

Dr. Jawahar R. ◽

◽

Dr. Renu G’Boy Varghese ◽

Dr. Thomas Alexander ◽

Dr. George Kurian ◽

...

Keyword(s):

Health Care ◽

Intestinal Metaplasia ◽

Care Setting ◽

Health Care Setting ◽

Gastric Intestinal Metaplasia ◽

H Pylori

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The Reduction in Gastric Atrophy after Helicobacter pylori Eradication Is Reduced by Treatment with Inhibitors of Gastric Acid Secretion

International Journal of Molecular Sciences ◽

10.3390/ijms20081913 ◽

2019 ◽

Vol 20 (8) ◽

pp. 1913 ◽

Cited By ~ 4

Author(s):

Ryota Niikura ◽

Yoku Hayakawa ◽

Yoshihiro Hirata ◽

Keiji Ogura ◽

Mitsuhiro Fujishiro ◽

...

Keyword(s):

Helicobacter Pylori ◽

Drug Use ◽

Intestinal Metaplasia ◽

Mixed Model ◽

Linear Mixed Model ◽

Eradication Therapy ◽

Gastric Atrophy ◽

H Pylori ◽

Surveillance Endoscopy

Background: Helicobacter pylori (H. pylori) eradication therapy may improve gastric atrophy and intestinal metaplasia, but the results of previous studies have not always been consistent. The aim of this study was to compare the histological changes of intestinal metaplasia and gastric atrophy among the use of acid-suppressing drugs after H. pylori eradication. Methods: A cohort of 242 patients who underwent successful eradication therapy for H. pylori gastritis and surveillance endoscopy examination from 1996 to 2015 was analyzed. Changes in the histological scores of intestinal metaplasia and atrophy according to drug use (proton-pump inhibitors (PPIs), H2 receptor antagonists (H2RAs), and non-acid suppressant use) were evaluated in biopsies of the antrum and corpus using a generalized linear mixed model in all patients. Results: The mean follow-up period and number of biopsies were 5.48 ± 4.69 years and 2.62 ± 1.67 times, respectively. Improvement in the atrophy scores of both the antrum (p = 0.042) and corpus (p = 0.020) were significantly superior in patients with non-acid suppressant drug use compared with those of PPI and H2RA use. Metaplasia scores in both the antrum and corpus did not improve in all groups, and no significant differences were observed among groups in the antrum (p = 0.271) and corpus (p = 0.077). Conclusions: Prolonged acid suppression by PPIs or H2RAs may limit the recovery of gastric atrophy following H. pylori eradication.

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