Análisis histopatológico semicuantitativo de la gastritis crónica: índice de extensión y grado / Histopathological semiquantitative analysis of chronic gastritis: extension and grade index

Three endoscopic systematic biopsies were obtained from 261 patients showing chronic gastritis. Histopathologic features of chronic gastritis were graded from 0 to 3 points according to the Sydney System. In addition, an extension and grading histopathologic score was applied. This score was obtained from the sum of qualified grades for each feature in all three samples. Inflammation, activity, atrophy and intestinal metaplasia were predominantly grade 1 and H pylori density was predominantly grade 2. Only 2,6 percent of the sections whith out atrophy showed intestinal metaplasia, while 79,3 percent of the sections depicting grade 2-3 intestinal metaplasia showed moderate to severe atrophy. Inflammation was more severe in antral lesser curvature and the more severe atrophy was present in the antrum than in the corpus mucosa. Sydney System and extension and grading histopathologic score showed more extensive activity in patients older than 45 years. A lower histopathologic score of H pylori was seen in these patients. The presence of H pylori was directly correlated with inflammation severity and inversely with atrophy. These results, in accordance with data shown in the literature, suggest that the Sydney System and extension and grading histopathologic score can be applied to compare chronic gastritis features in different groups of patients

Frecuencia y caracteres histopatológicos de gastritis crónica en 300 pacientes sin lesiones endoscópicas / Frequency and histopathologic features of chronic gastritis in 300 patients without endoscopic lesions

Three gastric mucosal biopsies were obtained from 300 patients showing a normal upper digestive tract endoscopy. Histologically in 9 percent of the patients the biopsies were normal; in 87 percent showed a common-type chronic gastritis and in 4 percent showed a reactive (chemical or reflux-type) gastritis. Helicobacter pylori was present in 25.9 percent of the patients without gastritis, in 33.3 percent of the patients with reactive gastritis and in 87.7 percent of those with common-type gastritis. In 19.9 percent of the patients with common-type chronic gastritis there was intestinal metaplasia, consisting of type I metaplasia in 14.1 percent, type II in 3.1 percent and type III metaplasia in 2.3 percent. The association of type III intestinal metaplasia with the other forms of metaplasia, its lower frequency and its tendency to be present in older patients supports the hipothesis that type III incomplete colonic metaplasia represents a more advanced stage than complete and incomplete small bowel metaplasia of the gastric mucosa