Nodular Gastritis as a Precursor Lesion of Atrophic and Metaplastic Gastritis
10.4166/kjg.2019.73.6.332
- Author:
Young Jung KIM
1
;
Sun Young LEE
;
Hojun YANG
;
Jeong Hwan KIM
;
In Kyung SUNG
;
Hyung Seok PARK
Author Information
1. Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea. sunyoung@kuh.ac.kr
- Publication Type:Original Article
- Keywords:
Gastritis;
Lymphoid tissue;
Atrophy;
Metaplasia
- MeSH:
Atrophy;
Diagnosis;
Endoscopy;
Endoscopy, Gastrointestinal;
Follow-Up Studies;
Gastritis;
Gastritis, Atrophic;
Helicobacter pylori;
Humans;
Lymphoid Tissue;
Metaplasia;
Precancerous Conditions;
Stomach Neoplasms
- From:The Korean Journal of Gastroenterology
2019;73(6):332-340
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Chronic atrophic gastritis (CAG) and metaplastic gastritis (MG) are precancerous conditions of Helicobacter pylori (H. pylori)-related gastric cancer. This study aimed to identify the characteristics of nodular gastritis (NG) showing CAG or MG after nodule regression. METHODS: H. pylori-infected patients with NG were included after upper gastrointestinal endoscopy. Patients were excluded if their latest endoscopy had been performed ≤36 months after the initial diagnosis of NG. Small-granular-type NG was defined as the condition with 1–2 mm regular subepithelial nodules. Large-nodular-type NG was defined as those with 3–4 mm, irregular subepithelial nodules. The endoscopic findings after nodule regression were recorded. RESULTS: Among the 97 H. pylori-infected patients with NG, 61 showed nodule regression after a mean follow-up of 73.0±22.0 months. After nodule regression, 16 patients showed a salt-and-pepper appearance and/or transparent submucosal vessels, indicating CAG. Twenty-nine patients showed diffuse irregular elevations and/or whitish plaques, indicating MG. Sixteen patients with other endoscopic findings (14 normal, one erosive gastritis, and one chronic superficial gastritis) showed a higher proportion of H. pylori eradication (12/16, 75.0%) than those in the CAG group (5/16, 31.3%) and MG group (6/29, 20.7%; p=0.001). Patients with small-granular-type NG tended to progress toward CAG (14/27, 51.9%), whereas those with large-nodular-type NG tended to progress toward MG (25/34, 73.5%; p<0.001). CONCLUSIONS: In patients with a persistent H. pylori infection, NG tended to progress to CAG or MG when the nodules regressed. Small-granular-type NG tended to progress to CAG, whereas large-nodular-type NG tended to progress to MG.
