Pancreatic acinar cell metaplasia in autoimmune gastritis.
OBJECTIVE
To determine the frequency and significance of pancreatic acinar cells in the gastric oxyntic mucosa.


METHODS
One hundred gastric oxyntic mucosal biopsy specimens from patients with chronic active gastritis (n = 30), multifocal atrophic gastritis (n = 15), autoimmune gastritis (n = 18), and normal gastric oxyntic mucosa (n = 37) were evaluated for the presence of pancreatic acinar cells. Formalin-fixed, paraffin-embedded tissues were stained with hematoxylin-eosin, and those positive for pancreatic acinar cells were immunostained with antibodies against trypsin and pancreatic amylase.


RESULTS
Eleven (11%) of 100 oxyntic mucosal tissue samples contained pancreatic acinar cells. These samples came from 9 of the 18 (50%) specimens of autoimmune gastritis, 1 of the 15 (6.6%) specimens of multifocal atrophic gastritis, and 1 of the 37 (2.7%) specimens of normal oxyntic mucosa. None of the samples with chronic active gastritis contained pancreatic acinar cells.


CONCLUSIONS
Pancreatic acinar cells were found in the oxyntic mucosa of patients with autoimmune gastritis significantly more frequently (P <.001) than in individuals with multifocal atrophic gastritis, normal oxyntic mucosa, or chronic active gastritis. Our study supports a metaplastic origin for pancreatic acinar cells in the oxyntic mucosa. Furthermore, detection of pancreatic acinar cells in the oxyntic mucosa of patients with gastritis strongly suggests an autoimmune pathogenesis.
Jhala
Nirag C
NC
Department of Pathology, Baylor College of Medicine, Houston, Tex, USA. njhala@path.uab.edu
Montemor
Mario
M
Jhala
Darshana
D
Lu
Lin
L
Talley
Lynya
L
Haber
Marian M
MM
Lechago
Juan
J
D001327:Autoimmune Diseases / Q000382:microbiology / Q000473:pathology; D002352:Carrier Proteins / Q000032:analysis; D005557:Formaldehyde; D005743:Gastrectomy; D005753:Gastric Mucosa / Q000473:pathology*; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology / Q000473:pathology*; D005757:Gastritis, Atrophic / Q000276:immunology / Q000473:pathology; D006023:Glycoproteins / Q000032:analysis; D016481:Helicobacter Infections / Q000175:diagnosis / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008049:Lipase; D008679:Metaplasia; D010179:Pancreas / Q000276:immunology / Q000473:pathology*; D016612:Paraffin Embedding; D010295:Parietal Cells, Gastric / Q000737:chemistry / Q000473:pathology; D016707:Tissue Fixation
D002352:Carrier Proteins; D005755:Gastrins; D006023:Glycoproteins; D005557:Formaldehyde; C054621:CEL protein, human; D008049:Lipase