Distinct metaplastic and inflammatory phenotypes in autoimmune and adenocarcinoma-associated chronic atrophic gastritis

作者：Jeong Sangho; Choi Eunyoung; Petersen Christine P; Roland Joseph T; Federico Alessandro; Ippolito Rossana; D'Armiento Francesco P; Nardone Gerardo; Nagano Osamu; Saya Hideyuki; Romano Marco; Goldenring James R^*

来源：United European Gastroenterology Journal, 2017, 5(1): 37-44.

DOI：10.1177/2050640616644142

• Spasmolytic polypeptide-expressing metaplasia
• intestinal metaplasia
• gastritis
• CD44 variant 9
• DMBT1
• macrophage
• neutrophil

Background Autoimmune gastritis (AIG) and adenocarcinoma-associated chronic atrophic gastritis (CAG) are both associated with oxyntic atrophy, but AIG patients demonstrate an increased risk of carcinoid tumors rather than the elevated risk of adenocarcinoma observed with CAG. We therefore sought to compare the characteristics of the metaplastic mucosa in AIG and CAG patients.
Methods We examined markers for metaplasia (spasmolytic polypeptide expressing metaplasia (SPEM) and intestinal metaplasia) as well as proliferation (Ki67) and immune cell populations (neutrophils, macrophages, and eosinophils) in gastric sections from 16 female patients with autoimmune thyroiditis and AIG and 17 patients with CAG associated with gastric adenocarcinoma.
Results Both AIG and CAG patients demonstrated prominent SPEM and intestinal metaplasia. However, AIG patients displayed significantly lower numbers of infiltrating macrophages and significantly reduced mucosal cell proliferation as compared to CAG patients.
Conclusions These findings indicate that, while both AIG and CAG patients display prominent oxyntic atrophy and metaplasia, the AIG patients do not show proliferative metaplastic lineages that would predispose to adenocarcinoma.

• 出版日期2017-2