Remnant gastritis should be evaluated histologically rather than endoscopically.
OBJECTIVE
Many patients who undergo distal gastrectomy develop remnant gastritis. The diagnosis of remnant gastritis is commonly established endoscopically. This report describes the correlation between endoscopic and histological findings of inflammatory changes in the remnant gastric mucosa.


METHODS
Ninety-seven patients who underwent curative distal gastrectomy for gastric cancer, with radical lymphadenectomy, were studied. Endoscopy was performed 12 weeks after surgery. Patients with marked redness, erosion, or edema of the gastric remnant, as seen by endoscopy, were judged to have remnant gastritis, and were divided into group P (positive) and group N (negative). Histological remnant gastritis was evaluated with the neutrophil infiltration score based on the updated Sydney System for endoscopically taken biopsies. Cyclooxygenase (COX)-2 expression was evaluated immunohistochemically.


RESULTS
There was no difference in neutrophil infiltration or COX-2 expression scores between the patients in groups P and N. There was a significant correlation between neutrophil infiltration score and COX-2 expression score (p<0.001).


CONCLUSIONS
Endoscopic diagnosis of remnant gastritis was not correlated with histological findings. Histological remnant gastritis had significant correlation with COX-2 expression score, which was induced by inflammation. Therefore, proper diagnosis of remnant gastritis should be based on histological examination.
Fukuhara
Kenichiro
K
Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Osugi
Harushi
H
Lee
Shigeru
S
Morimura
Keiichirou
K
Kishida
Satoru
S
Nishizawa
Satoshi
S
Iwasaki
Hiroshi
H
Gyobu
Ken
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D051546:Cyclooxygenase 2 / Q000378:metabolism; D004724:Endoscopy; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D018530:Gastric Stump; D005756:Gastritis / Q000201:enzymology / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020556:Neutrophil Infiltration; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery*
D051546:Cyclooxygenase 2