Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2021; 9(16): 3838-3847
Published online Jun 6, 2021. doi: 10.12998/wjcc.v9.i16.3838
Histopathological classification and follow-up analysis of chronic atrophic gastritis
Yang-Kun Wang, Lan Shen, Tian Yun, Bin-Feng Yang, Chao-Ya Zhu, Su-Nan Wang
Yang-Kun Wang, Department of Pathology, Shenzhen Hospital of Southern Medical University, Shenzhen 518100, Guangdong Province, China
Lan Shen, Department of Pathology, Shenzhen Hospital of Southern Medical University, Shenzhen 518055, Guangdong Province, China
Tian Yun, Department of Pathology, 989th Hospital of PLA, Luoyang 471000, Henan Province, China
Bin-Feng Yang, Department of Pathology, Xinxiang Central Hospital, Xinxiang 453000, Henan Province, China
Chao-Ya Zhu, Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Su-Nan Wang, Shenzhen Vocational and Technical College, Shenzhen 518055, Guangdong Province, China
Author contributions: Wang YK and Wang SN participated in the design of this study, and they both performed the statistical analysis; Shen L, Yun T, Yang BF, and Zhu CY carried out the study and collected important background information; Wang YK, Shen L, and Yun T drafted the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by Luoyang Medical Research Institutional Review Board.
Informed consent statement: All subjects gave written informed consent prior to study inclusion.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Su-Nan Wang, PhD, Research Assistant Professor, Shenzhen Vocational and Technical College, Bank of Xili Lake, Xilihu Town, Nanshan District, Shenzhen 518055, Guangdong Province, China. wangsunan@szpt.edu.cn
Received: August 5, 2020
Peer-review started: August 5, 2020
First decision: October 18, 2020
Revised: November 12, 2020
Accepted: March 18, 2021
Article in press: March 18, 2021
Published online: June 6, 2021
Processing time: 282 Days and 7 Hours
Abstract
BACKGROUND

The pathological diagnosis and follow-up analysis of gastric mucosal biopsy have been paid much attention, and some scholars have proposed the pathological diagnosis of 12 kinds of lesions and accompanying pathological diagnosis, which is of great significance for the treatment of precision gastric diseases, the improvement of the early diagnosis rate of gastric cancer, and the reduction of missed diagnosis rate and misdiagnosis rate.

AIM

To perform a histopathological classification and follow-up analysis of chronic atrophic gastritis (CAG).

METHODS

A total of 2248 CAG tissue samples were collected, and data of their clinical characteristics were also gathered. Based on these samples, the expression levels of Mucin 1 (MUC1), MUC2, MUC5AC, and MUC6 in CAG tissue were tested by immunohistochemical assay. Moreover, we followed these patients for up to four years. The difference between different stages of gastroscopic biopsy was observed.

RESULTS

Through observation, it is believed that CAG should be divided into four types, simple type, hyperplasia type, intestinal metaplasia (IM) type, and intraepithelial neoplasia (IEN) type. Simple CAG accounted for 9.1% (205/2248), which was more common in elderly people over 60 years old. The main change was that the lamina propria glands were reduced in size and number. Hyperplastic CAG accounted for 29.1% (654/2248), mostly occurring between 40 and 60 years old. The main change was that the lamina propria glands were atrophy accompanied by glandular hyperplasia and slight expansion of the glands. IM CAG accounted for 50.4% (1132/2248), most of which increased with age, and were more common in those over 50 years. The atrophy of the lamina propria glands was accompanied by significant IM, and the mucus containing sialic acid or sulfate was distinguished according to the nature of the mucus. The IEN type CAG accounted for 11.4% (257/2248), which developed from the previous types, with severe gland atrophy and reduced mucus secretion, and is an important precancerous lesion.

CONCLUSION

The histological typing of CAG is convenient to understand the property of lesion, determine the follow-up time, and guide the clinical treatment.

Keywords: Gastric mucosal biopsy; Chronic atrophic gastritis; Histological typing; Immunohistochemistry; Follow-up review

Core Tip: The pathological diagnosis and follow-up analysis of gastric mucosal biopsy have been paid much attention, and we aimed to perform a histopathological classification and follow-up analysis of chronic atrophic gastritis. The current research results are useful for clinicians to understand the nature and development of the disease, and are important for precision treatment and tracking of malignant transformation.