title: Comprehensive investigation of areae gastricae pattern in gastric corpus using magnifying narrow band imaging endoscopy in patients with chronic atrophic fundic gastritis.
abstract: BACKGROUND
  Barium radiographic studies have suggested the importance of evaluating areae gastricae pattern for the diagnosis of gastritis. Significance of endoscopic appearance of areae gastricae in the diagnosis of chronic atrophic fundic gastritis (CAFG) was investigated by image-enhanced endoscopy.
  
  
  METHODS
  Endoscopic images of the corpus lesser curvature were studied in 50 patients with CAFG. Extent of CAFG was evaluated with autofluorescence imaging endoscopy. The areae gastricae pattern was evaluated with 0.2% indigo carmine chromoendoscopy. Micro-mucosal structure was examined with magnifying chromoendoscopy and narrow band imaging.
  
  
  RESULTS
  In patients with small extent of CAFG, polygonal areae gastricae separated by a narrow intervening part of areae gastricae was observed, whereas in patients with wide extent of CAFG, the size of the areae gastricae decreased and the width of the intervening part of areae gastricae increased (p < 0.001). Most areae gastricae showed a foveola-type micro-mucosal structure (82.7%), while intervening part of areae gastricae had a groove-type structure (98.0%, p < 0.001). Groove-type mucosa had a higher grade of atrophy (p < 0.001) and intestinal metaplasia (p < 0.001) compared with foveola type.
  
  
  CONCLUSIONS
  As extent of CAFG widened, multifocal groove-type mucosa that had high-grade atrophy and intestinal metaplasia developed among areae gastricae and increased along the intervening part of areae gastricae. Our observations facilitate our understanding of the development and progression of CAFG.
authors.affiliation: Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-ku, Osaka, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kanzaki
authors.forename: Noriya
authors.initials: N
authors.lastname: Uedo
authors.forename: Ryu
authors.initials: R
authors.lastname: Ishihara
authors.forename: Kengo
authors.initials: K
authors.lastname: Nagai
authors.forename: Fumi
authors.initials: F
authors.lastname: Matsui
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohta
authors.forename: Masao
authors.initials: M
authors.lastname: Hanafusa
authors.forename: Noboru
authors.initials: N
authors.lastname: Hanaoka
authors.forename: Yoji
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Koji
authors.initials: K
authors.lastname: Higashino
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iishi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tomita
authors.forename: Masaharu
authors.initials: M
authors.lastname: Tatsuta
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005757:Gastritis, Atrophic / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D016480:Helicobacter pylori / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged