title: Histopathology of gastric erosions. Association with etiological factors and chronicity.
abstract: BACKGROUND
  The histopathologic characteristics of the antral erosions, and a comparison with samples systematically collected from the background antral mucosa, have not been studied previously. Similarly, unknown is the association of these features with suspected etiological factors and chronicity of erosion.
  
  
  METHODS
  We studied 117 patients with gastric erosions in the absence of peptic ulcer disease. With 28 patients available for a follow-up 19 years later, sites of erosions and background mucosa were biopsied and histopathology of both independently assessed at both visits. Helicobacter pylori status was examined from the biopsies taken in the initial and follow-up gastroscopies. Only subjects originally displaying antral erosions were included. The presence of Herpes simplex virus (HSV) antibodies was analyzed and use of nonsteroidal anti-inflammatory drug (NSAID) was inquired.
  
  
  RESULTS
  Initially, the inflammation was more active in the region of erosions than elsewhere in antral mucosa. More active inflammation in the erosion was associated with HSV seropositivity, Helicobacter pylori infection, and the recent use of NSAIDs. In the follow-up visit, antral erosions were present in 38% (3/8) of Helicobacter pylori negatives and in 35% (7/20) of positives (p = ns). The Helicobacter pylori positive subjects with chronic or recurrent erosions had initially higher scores of neutrophils compared to subjects with nonrecurrent or nonchronic erosions (2.7 ± 0.5 vs 1.2 ± 1.0; p = .002).
  
  
  CONCLUSIONS
  Focally enhanced inflammation is characteristic for gastric erosions. This focal inflammation was associated with HSV seropositivity or NSAID use suggesting that such inflammation may be important in the pathogenesis of gastric antral erosions. Highly active inflammation in the erosions associates with their chronicity.
authors: Department of Internal Medicine, Division of Gastroenterology, University of Oulu, PL 5000, FI-90014 Oulu, Finland. kari.toljamo@tyks.fi
authors: Kari
authors: K
authors: Toljamo
authors: Seppo
authors: S
authors: Niemelä
authors: Anna-Liisa
authors: AL
authors: Karvonen
authors: Riitta
authors: R
authors: Karttunen
authors: Tuomo J
authors: TJ
authors: Karttunen
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000914:Antibodies, Viral / Q000097:blood; D001706:Biopsy; D002908:Chronic Disease; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006651:Histocytochemistry; D006801:Humans; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D011706:Pyloric Antrum / Q000473:pathology*; D018139:Simplexvirus / Q000276:immunology; D013272:Stomach Diseases / Q000209:etiology* / Q000473:pathology*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000914:Antibodies, Viral