Sangho Jeong1, Eunyoung Choi2, Christine P Petersen3, Joseph T Roland3, Alessandro Federico4, Rossana Ippolito5, Francesco P D'Armiento5, Gerardo Nardone6, Osamu Nagano7, Hideyuki Saya7, Marco Romano4, James R Goldenring8. 1. Department of Surgery, Vanderbilt University School of Medicine, USA; Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, USA; Department of Surgery of Postgraduate School of Medicine, Gyeongsang National University, South Korea. 2. Department of Surgery, Vanderbilt University School of Medicine, USA. 3. Department of Surgery, Vanderbilt University School of Medicine, USA; Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, USA. 4. Department of Internal Medicine-Gastroenterology, Second University of Naples, Italy. 5. Department of Pathology, Federico II University, Italy. 6. Department of Medicine-Gastroenterology, Federico II University, Naples, Italy. 7. Division of Gene Regulation, Keio University, Japan. 8. Department of Surgery, Vanderbilt University School of Medicine, USA; Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, USA; Nashville VA Medical Center, Vanderbilt University School of Medicine, USA.
Abstract
BACKGROUND: Autoimmune gastritis (AIG) and adenocarcinoma-associated chronic atrophic gastritis (CAG) are both associated with oxyntic atrophy, but AIG patients demonstrate an increased risk of carcinoid tumors rather than the elevated risk of adenocarcinoma observed with CAG. We therefore sought to compare the characteristics of the metaplastic mucosa in AIG and CAG patients. METHODS: We examined markers for metaplasia (spasmolytic polypeptide expressing metaplasia (SPEM) and intestinal metaplasia) as well as proliferation (Ki67) and immune cell populations (neutrophils, macrophages, and eosinophils) in gastric sections from 16 female patients with autoimmune thyroiditis and AIG and 17 patients with CAG associated with gastric adenocarcinoma. RESULTS: Both AIG and CAG patients demonstrated prominent SPEM and intestinal metaplasia. However, AIG patients displayed significantly lower numbers of infiltrating macrophages and significantly reduced mucosal cell proliferation as compared to CAG patients. CONCLUSIONS: These findings indicate that, while both AIG and CAG patients display prominent oxyntic atrophy and metaplasia, the AIG patients do not show proliferative metaplastic lineages that would predispose to adenocarcinoma.
BACKGROUND:Autoimmune gastritis (AIG) and adenocarcinoma-associated chronic atrophic gastritis (CAG) are both associated with oxyntic atrophy, but AIG patients demonstrate an increased risk of carcinoid tumors rather than the elevated risk of adenocarcinoma observed with CAG. We therefore sought to compare the characteristics of the metaplastic mucosa in AIG and CAG patients. METHODS: We examined markers for metaplasia (spasmolytic polypeptide expressing metaplasia (SPEM) and intestinal metaplasia) as well as proliferation (Ki67) and immune cell populations (neutrophils, macrophages, and eosinophils) in gastric sections from 16 female patients with autoimmune thyroiditis and AIG and 17 patients with CAG associated with gastric adenocarcinoma. RESULTS: Both AIG and CAG patients demonstrated prominent SPEM and intestinal metaplasia. However, AIG patients displayed significantly lower numbers of infiltrating macrophages and significantly reduced mucosal cell proliferation as compared to CAG patients. CONCLUSIONS: These findings indicate that, while both AIG and CAG patients display prominent oxyntic atrophy and metaplasia, the AIG patients do not show proliferative metaplastic lineages that would predispose to adenocarcinoma.
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