Different Pattern of Inflammatory and Atrophic Changes in the Greater and Lesser Curvature of the Gastric Mucosa

Abstract

Background: The extent of inflammation and atrophy of different regions of the stomach in patients with chronic gastritis have been addressed only in few studies.The aim of our study was to analyze the inflammatory, atrophic, metaplastic changes and H. pylori colonization in the greater and lesser curvature of the antrum and corpus mucosa.Patients and methods. 423 patients undergoing upper endoscopy were enrolled in the study. Five biopsy samples was available (two samples from the greater and lesser curvatures of antral mucosa, one from the mucosa of the lesser curvature of incisura angularis, and two from the anterior and posterior walls of the corpus. Three expert gastrointestinal pathologists graded biopsy specimens according to the updated Sydney classification. Giemsa and immunohistochemical staining was used for the detection of H. pylori.Results. Obtained results showed that the acute and chronic inflammatory changes were more prominent in the corpus lesser curvature compared to corpus greater curvature (p = 0.01 and p = 0.0001, respectively). In addition, the extent and degree of atrophy and intestinal metaplasia (IM) was more prominent in corpus lesser curvature compared to greater curvature (p = 0.002 and p = 0.0065, respectively). Furthermore, H. pylori tend to be more frequently found in the corpus lesser curvature compared to greater curvature. Furthermore, differences between the inflammatory, atrophic, metaplastic changes and H. pylori colonization was observed in the antrum greater and lesser curvature.Conclusion. The findings confirm that random biopsy specimens have to be obtained both: from lesser and greater curvature to achieve better reliability.