Atrophic gastritis does not produce any pathognomonic signs over a long period of time and therefore, the diagnosis of chronic atrophic gastritis is mainly morphological. The main method of diagnostics of atrophic gastritis is endoscopic examination with further targeted multiple biopsy. The gastric mucosa has characteristic differences in severe and widespread atrophy, and in minor atrophic changes visually it slightly differs from superficial gastritis. Therefore, histological examination of the gastric mucosa is of decisive significance, and it is the “golden standard” of disease verification. In chronic atrophic multifocal gastritis (CAMG) atrophic changes prevailed (54.64%), and in the quarter of patients antrum was damaged. In chronic autoimmune gastritis (CAG) the foci of atrophy were mainly localized in the body of the stomach (58.63%, р<0.001), while diffuse damages (24.14%, р<0.01) and antral gastritis (6.89%, р<0.01) were rarely diagnosed. Neutrophilic infiltration of antrum MM was diagnosed in 54.64% of patients with CAMG. Moreover, the distribution according to the stages of activity was homogeneous. Total active (slight and moderate level) autoimmune gastritis was diagnosed in 62.07% of patients. The severity of the inflammatory process was characteristic for both forms of atrophic gastritis, however, in patients with CAMG monocyte-plasmatic infiltration of the lamina propria of the body and antrum, and in patients with CAG lymphocytic infiltration predominated. Atrophic alterations were diagnosed in all bioptates taken from antral part of the stomach in CAMG and body of the stomach in CAG. In CAMG there were found slight and pronounced levels of atrophy in antrum more often (39.18%, 31.95%, р<0.05), and moderately pronounced level of atrophy was more frequently found in the stomach body. Atrophy of fundal part of the stomach in first-degree and second-degree CAG was diagnosed in 41.38%, and 31.03% of patients (р1<0.05, р1<0.01). The dependence between the activity of inflammation, density of monocyte-plasmatic infiltration and development of atrophic alterations (r=0.64, p<0.001; r=0.58, p<0.01) was found in patients with CAMG. Correlation dependence of neutrophilic-lymphocytic manifestation of inflammation (r=0.81, p<0.001) was found in the expression of the process into the stomach body.
Аruin L.I., Kapuller L.L., Isakov V.A. Morphological diagnostics of the gastrointestinal diseases. Moscow. Triada. 1998; 483.
Аruin L.I. New international morphological classification of gastritis (modification of the Sydney system). Rossiyskiy zhurnal gastroenterologiyi, gepatologiyi, koloproktologiyi. 1997; 8(3): 82–85.
Babak О. Ya. Atrophic gastritis: prognosis and perspectives. Zdorovia Ukraiiny. 2006; 21(1): 26–27.
Babak О. Ya., Fadeyenko G.D. Morphological changes in the gastric mucosa in chronic atrophic gastritis after anti-helicobacter therapy. Suchasna hastroenterolohiia. 2007; 6 (38): 36–39.
Babak О. Ya. Modern conception about the evaluation of risk of the development and prevention of stomach cancer. Suchasna hastroenterolohiia. 2009; 6 (50): 62–66.
Kogan E.A., Tyurin V.P., Kreymer V.D. Atrophic gastritis as a precancerous state of the stomach: new view at the old problem. Klin. med. 2011; 1: 34–37.
Kononov A.V., Mozgovoy S.I., Livzan M.A. et al. Morphology of superficial and atrophic gastritis in eradication of Helicobacter pylori. Arkhiv patologiyi. 2005; 67(3): 17–20.
Kuryk O.H., Soloviova H.A., Yakovenko V.O. Chronic gastritis and precancerous changes of the gastric mucosa: morphological aspects. Suchasna hastroenterolohiia. 2009; 4 (48): 88–93.
Naumova L.A., Paltsev A.I., Beliaieva Ya.Yu. Peculiarities of clinical-morphological manifestations of atrophic process in the gastric mucosa in the absence and presence of infection of Неlісоbасtеr руlоrі (stage I). Eksper. i kiln. gastroenterol. 2005; 2: 22–28.
Stepanov Yu.M., Zak M.Yu., Mosiichuk L.M. Atrophic gastritis: optimization of diagnostics, classification and prognostication: Method. recommendations. Kyiv. 2012; 32.
Fadeyenko H.D., Prosolenko K.O., Solomentseva T.A. Atrophic gastritis: mechanisms of appearance, some questions of diagnostics and reversibility of development. Suchasna hastroenterolohiia. 2007; 2 (34): 8–12.
Rugge M. et al. Gastric mucosal atrophy: interobserver consistency using new criteria for classification and grading. Aliment. Pharmacol. Ther. 2002; 16: 1249–1259.
Sipponen P. Update on the pathologic approach to the diagnosis of gastritis, gastric atrophy and Helicobacter pylori and its sequelae. J. Clin. Gastroenterol. 2001; 32:196–202.
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