Nodular gastritis in Japanese young adults: endoscopic and histological observations.
BACKGROUND
Endoscopic findings of nodular gastritis (NG) are characterized by the presence of Helicobacter pylori infection and follicular gastritis. A possible association with diffuse-type gastric cancer has recently been suggested from observations in Japanese. Our aim was to analyze antral nodularity and histological scores in young adults.


METHODS
Subjects (55 men and 45 women; age range, 18-25 years) with upper gastrointestinal (GI) symptoms or positive H. pylori antibodies underwent endoscopy. One specimen each was obtained from the greater and lesser curvatures (curves) of the corpus and from those of the antrum. Endoscopic appearance was assessed using 0.2% indigo carmine, and histopathological grading was evaluated by the updated Sydney System.


RESULTS
Antral nodularity was identified in none of 17 H. pylori-negative subjects and in 55 of 83 (66.3%) H. pylori-positive subjects. By the distribution of nodular or granular elevated lesions in the antrum, NG was divided into diffuse (n = 27) or nondiffuse (n = 28) types. The diffuse-type NG predominantly affected women (odds ratio, 3.9; 95% confidence interval, 1.5-10). The atrophy scores in the lesser curve of the antrum were significantly higher in the nondiffuse than in the diffuse group. However, the scores for activity, inflammation, and H. pylori density were not significantly different among the three groups.


CONCLUSIONS
Diffuse-type NG depended on sex, and antral nodularity seemed to change from the diffuse to the nondiffuse type in association with atrophy.
Shiotani
Akiko
A
Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
Kamada
Tomoari
T
Kumamoto
Mitsutaka
M
Nakae
Yukinori
Y
Nakamura
Yasushi
Y
Kakudo
Kenichi
K
Haruma
Ken
K
D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis; D044466:Asian People; D004396:Coloring Agents; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D005757:Gastritis, Atrophic / Q000208:ethnology / Q000209:etiology / Q000473:pathology*; D005773:Gastroscopy / Q000379:methods*; D016481:Helicobacter Infections / Q000150:complications / Q000208:ethnology / Q000473:pathology; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007203:Indigo Carmine; D007564:Japan / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014741:Video Recording
D000907:Antibodies, Bacterial; D004396:Coloring Agents; D007203:Indigo Carmine
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