Intestinal metaplasia in portal hypertensive gastropathy: a frequent pathology.
OBJECTIVE
To compare the frequency of intestinal metaplasia (IM) in patients with portal hypertensive gastropathy (PHG) to the control group with functional dyspepsia.


METHODS
Two-hundred and eighty-nine cases were prospectively evaluated in three groups (controls:group I--123 patients; cirrhotics: group II--135 patients; noncirrhotic portal hypertensives: group III--31 patients). Mucosal biopsies (three antrum, one angulus, two corpus) were taken and examined for atrophy, IM, dysplasia, Helicobacter pylori (Hp) and histologic PHG.


RESULTS
Frequencies of IM in groups I, II and III were 17.1% (type I, 3.3%; type II, 10.6%; type III, 3.3%), 34.3% (type I, 9.6%; type II, 17%; type III, 6.7%) and 33.3% (type I, 9.7%; type II, 12.9%; type III, 9.7%), respectively. In patients with PHG, frequency of IM was significantly higher than in control group (P<0.05) and correlated with the severity of PHG (P<0.05). The frequency of type III IM was not statistically different among the three groups. Frequency of atrophy in cirrhotic patients was higher than in control group (17.9% in group I, 32.6% in group II, 25.8% in group III; P<0.05). In the control group, Hp prevalence was significantly higher than in patients with PHG (P<0.05) and there was a positive correlation between Hp and atrophy (P<0.05). In multivariate analysis, PHG and age were found as independent predictors for IM; PHG, age and Hp for atrophy.


CONCLUSIONS
Frequencies of atrophy and IM are higher in patients with PHG. PHG is a reliable marker for IM and atrophy in gastric mucosa.
Ibrişim
Duygu
D
Department of Gastroenterohepatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. duygu@ibrisim.net
Cevikbaş
Uğur
U
Akyüz
Filiz
F
Poturoğlu
Sule
S
Ahishali
Emel
E
Güllüoğlu
Mine
M
Demir
Kadir
K
Beşişik
Fatih
F
Boztaş
Güngör
G
Ozdil
Sadakat
S
Cakaloğlu
Yilmaz
Y
Mungan
Zeynel
Z
Okten
Atilla
A
Kaymakoğlu
Sabahattin
S
D000328:Adult; D000367:Age Factors; D001706:Biopsy; D004415:Dyspepsia / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005757:Gastritis, Atrophic / Q000209:etiology / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000473:pathology*; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D011446:Prospective Studies