Back ground: Chronic gastritis defined as histopathological entity that characterized by chronic inflammation of the gastric mucosa. There are three different types can be distinguished: gastritis A the result of an autoimmunological process with antibodies against parietal cells and intrinsic factor and is confined to the proximal stomach. Distal, antral gastritis B which is caused by an infection of the gastric mucosa with H. pylori. Gastritis C may be caused by drugs and alcohol but is mainly found in gastric remnants after partial resection as a consequence of biliary reflux.
Aim: To give a detailed histolopathological study of chronic gastritis with and without intestinal metaplasia and relationship between H pylori infection and chronic gastritis at GIT center at Babylon according to the Modified Sydney system.
Methods: Gastroscopic biopsy specimens from 50 consecutive patients from GIT center at Babylon were examined histologically after staining with hematoxylin /eosin and modified giemsa stain and graded according to the Updated Sydney System for H. pylori infection, chronic inflammation, neutrophil activity, glandular atrophy and intestinal metaplasia.
Results: The rate of the graded variables, in the antrum and corpus respectively, were as follows: H pylori infection (82%, 78 %), chronic inflammation (98%, 78%), neutrophil activity (70%, 62%), glandular atrophy (12%,8%) and intestinal metaplasia (11%, 5%). Significant association was found between the degree of H pylori colonization with chronic inflammation, less degree of neutrophil activity and antral glandular atrophy. Biopsies from the antrum and corpus showed significant histopathological discordance for all the graded variables.
Conclusion: The study shows that the majority of patients show a mild to moderate degree of inflammation with or without intestinal metaplasia, still less degree of glandular atrophy some time present. The study confirms that H pylori is the chief cause of gastritis in the study patients. The study also shows that interrelationships between the histological variables in those patients are similar to those found in other populations worldwide. |