Medizinische Universität Graz - Research portal
Selected Publication:
Wolf, EM.
Evolving Patterns in the Histologic Diagnosis of Gastritis
[ Diplomarbeit ] Medical University of Graz; 2013. pp. 69
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- Authors Med Uni Graz:
- Advisor:
- Langner Cord
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- Abstract:
- Aims: The study aimed to assess the prevalence of different types of gastritis, to investigate histologic parameters arguing in favour of or against reactive gastropathy, and to correlate histologic findings with clinical symptoms and the endoscopic diagnosis of gastritis. Methods: A total of 1,123 individuals participated in a prospective multicentre study. Endoscopists classified individuals as positive or negative for gastritis and rendered the putative cause. Histologic diagnosis of Helicobacter gastritis was made according to the Updated Sydney System. Diagnosis of reactive gastropathy was based upon Dixon¿s parameters of foveolar hyperplasia, smooth muscle fibres in the lamina propria, and vasodilatation and congestion of superficial mucosal capillaries. Adding paucity of acute and chronic inflammatory cells to analysis, a new score with visual analogue scales for the diagnosis of reactive gastropathy was developed. Results: Histologic diagnosis of gastritis was made in 639 (56.9%) participants. In all, 210 (18.7%) individuals were diagnosed with Helicobacter gastritis, 215 (19.1%) with post Helicobacter gastritis, 234 (20.8%) with reactive gastropathy, 26 (2.3%) with autoimmune gastritis, and 6 (0.5%) with focally enhanced gastritis related to Crohn¿s disease, respectively. All three histologic parameters in favour of the diagnosis of reactive gastropathy were positively associated with the endoscopic diagnosis of gastritis, yet negatively associated with Helicobacter infection. In contrast, the presence of acute and chronic inflammatory cells in the lamina propria was positively associated with Helicobacter infection. No association between diagnosis of Helicobacter gastritis and endoscopic diagnosis of gastritis was observed. Integrating the histologic parameters in the proposed score (-6 to 18) demonstrated strong association between histologic and endoscopic diagnosis of gastritis. Conclusions: Reactive gastropathy was more common than active Helicobacter gastritis. Agreement between histologic and endoscopic diagnoses was better in reactive gastropathy than in Helicobacter gastritis. The proposed score with visual analogue scales may enhance diagnostic accuracy of the histologic diagnosis of gastritis. It should be validated in future studies.