[Immunohistochemical detection of biomolecular markers for metaplastic mucosal atrophy in gastric biopsy specimens].

OBJECTIVE: To estimate the validity of the signs of metaplastic atrophic gastritis to elaborate a marker principle of its detection. SUBJECTS AND METHODS: Two hundred diagnostic cases morphologically diagnosed with chronic gastritis were selected for examination. The validity of the histological and immunohistochemical signs/markers reflecting a gland abnormality (hyperplasia of smooth muscle cells and argyrophilic and elastic fibers) and a cell phenotype change (intestinal and pyloric metaplasia): CDX-2, Shh, villin, CD10, MUC2, and MUC5AC was estimated in gastric biopsy specimens with atrophic gastritis forms verified in accordance with international classifications. The validity of the signs/markers was assessed, by calculating the sensitivity, specificity, prognostic value of positive and negative results, and positive and negative likelihood ratios. RESULTS: There were 3 molecules: CDX-2 is a nuclear transcription factor associated with intestinal differentiation; CCD10 is a brush border membrane-bound mycin and MUC2 is an intestinal-type mycin, which showed a high validity like the markers of metaplastic atrophic gastritis. An algorithm that could probably evaluate atrophic gastritis was elaborated for the successive immunohistochemical identification of the above-mentioned marker. CONCLUSION: The proposed technical decision to verify atrophic gastritis by the biomarker method may be not an alternative, but complementary technique of identifying the form of atrophic gastritis.

[The Russian revision of chronic gastritis classification: reproducibility of the pathomorphologic picture].

The estimation of Russian revision reproducibility of the chronic gastritis OLGA system International classification has been spent. The analysis of Russian pathologists-experts work, considered in estimations of an expression level and prevalence of gastric mucosal atrophic changes, as a tumour predictor, for the identification of chronic gastritis stages (0-IV) has been carried out by kappa-statistics. The different levels of experts' consent according to consent criteria calculation have been estimated. The criteria of consent (k) of leading Russian pathologists have been 0.5 (moderate level of the agreement). In the practice of histopathology researchers' classification a consent level has been lower--from 0.27 (satisfactory or tolerable consent level) to 0.42 (moderate or average consent level). A subjective reasons reducing consistency level of pathologists-experts have been discussed.

[Proliferative and mucin-producing activities in the foci of intestinal metaplasia associated with chronic atrophic gastritis and gastric ulcer].

Immunohistochemical studies revealed the dependence of cell regeneration parameters at sites of intestinal metaplasia (IM) in gastric mucosa (GM) on the character of the background events, such as atrophy and erosive-ulcerative defect. Mucin profile was determined in various types of IM. The intestinal type of mucin was found only in type I IM while types II and III were characterized by the mixed gastrointestinal phenotype with expression MUCSAC and MUC2. It was shown that at sites of incomplete IM (types II and III) and atrophic changes of GM cells proliferation activity of epithelium is considerably increased; this increase may be associated with the risk of developing gastric cancer of the intestinal type.

[International classification of chronic gastritis: what should be taken and what is in doubt].

The authors review the used classifications of chronic gastritis: Modified Sydney system, Atrophy Club classification, and Operative Link for Gastritis Assessment (OLGA). Their concept apparatus: the grade and stage of gastritis, intestinal metaplasia as a marker of gastric mucosal athrophy is considered. The possibilities of interpreting the pathologist's report and clinicomorphological comparisons are discussed. The OLGA Classification, which is to predict the gastric cancer risk determined by the degree of mucosal atrophy (a stage of chronic gastritis), is noted to have an indubitable merit. A simplified classification, according to which the grade and stage of gastritis are determined by the modified visual analog scale for mucosal changes in the body of the stomach and its antral part, is proposed. Whether the postmortem study protocol for gastric biopsy specimens can be modified is discussed.

[Algorithm for determination of the type of the gastric mucosa metaplasia by combined histochemical procedures].

It is necessary to detect intestinal metaplasia of the gastric mucosa to evaluate atrophic changes and to predict a risk of gastric cancer. An algorithm has been proposed to detect intestinal metaplasia, by indicating the basic combined procedures of histochemical identification. The procedures are described in the paper. The application of the algorithm will make it possible to rapidly determine a choice of adequate staining techniques for histopathological specimens and to achieve unambiguity in its interpretation by different pathologists, which is an important condition for the standardization of a pathologist's report.

[Clinical course of Helicobacter pylori associated chronic gastritis in post-eradicational period].

Results of a prospective cohort study of Helicobacter pylori associated chronic gastritis in posteradicational period have been analyzed in the paper. Different versions and prognostic markers in posteradicational period were identified. Curation algorithm for a patient with chronic gastritis after antihelicobacter therapy was suggested.

[Morphology of surface and atrophic gastritis in eradication of Helicobacter pylori (HP)].

It is shown with the use of immunohistochemical detection of Bcl-2, caspase-3 and Ki-67 that eradication of HP does not result in immediate reverse development of atrophic changes. This depends on duration of persistence of mononuclear inflammatory cells.

[Ex-Helicobacter gastritis: is it a neologism or clinical reality?]. / Eks-khelikobakternyi gastrit: neologizm ili klinicheskaia real'nost?

The article examines variants of the course of chronic nonatrophic gastritis during the post-eradication period (ex-Helicobacter gastritis). The term "ex-Helicobacter gastritis" has been substantiated as the gastritis onset as a result of Helicobacter pylori infection, the course of which does not depend on the therapeutic scheme of the bacteria elimination. The algorithm of the patient treatment upon the anti-HP therapy has been discussed.