title: Different Pattern of Inflammatory and Atrophic Changes in the Gastric Mucosa of the Greater and Lesser Curvature.
abstract: OBJECTIVE
  Appropriate biopsy sampling is important for the classification of gastritis, yet the extent of inflammation and atrophy of different regions of the stomach with chronic gastritis have been addressed only in a few studies. The aim of our study was to analyze the inflammatory, atrophic and metaplastic changes in the greater and lesser curvature of the antrum and corpus mucosa.
  
  
  METHODS
  420 patients undergoing upper endoscopy were enrolled in the study. Four expert gastrointestinal pathologists graded biopsy specimens according to the updated Sydney classification.
  
  
  RESULTS
  The obtained results showed that the mononuclear and granulocyte inflammatory cells were more prominent in the corpus lesser curvature compared to the corpus greater curvature (p=0.01 and p=0.0001, respectively). In addition, the extent and degree of atrophy and intestinal metaplasia were more prominent in the corpus lesser compared to the greater curvature (p=0.002 and p=0.0065, respectively). The frequency of distribution of H. pylori did not differ throughout both the corpus and antrum greater and lesser curvature. However, the degree of H. pylori colonization in the corpus was higher in the lesser than in the greater curvature. The interobserver agreement was significantly higher for corpus atrophy compared to antrum atrophy.
  
  
  CONCLUSIONS
  These findings demonstrated that the more severe atrophic, metaplastic and inflammatory changes were observed in the lesser compared to the greater curvature of the stomach. In routine clinical settings, corpus and antral biopsies should be obtained from both lesser and greater curvature. Analysis of the incisura biopsy is also important.
authors.affiliation: Faculty of Medicine,University of Latvia,Riga, Latvia. sergisajevs@inbox.lv.
authors.forename: Sergejs
authors.initials: S
authors.lastname: Isajevs
authors.affiliation: Faculty of Medicine,University of Latvia,Riga, Latvia.
authors.forename: Inta
authors.initials: I
authors.lastname: Liepniece-Karele
authors.affiliation: Faculty of Medicine,University of Latvia,Riga, Latvia.
authors.forename: Darja
authors.initials: D
authors.lastname: Svirina
authors.affiliation: Faculty of Medicine,University of Latvia,Riga, Latvia.
authors.forename: Daiga
authors.initials: D
authors.lastname: Santare
authors.affiliation: Faculty of Medicine,University of Latvia,Riga, Latvia.
authors.forename: Sandris
authors.initials: S
authors.lastname: Kaidaks
authors.affiliation: Faculty of Medicine,University of Latvia,Riga, Latvia.
authors.forename: Armands
authors.initials: A
authors.lastname: Sivins
authors.affiliation: Faculty of Medicine,University of Latvia,Riga, Latvia.
authors.forename: Uldis
authors.initials: U
authors.lastname: Vikmanis
authors.affiliation: Faculty of Medicine,University of Latvia,Riga, Latvia.
authors.forename: Marcis
authors.initials: M
authors.lastname: Leja
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D005757:Gastritis, Atrophic / Q000382:microbiology / Q000473:pathology*; D006098:Granulocytes / Q000473:pathology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011706:Pyloric Antrum / Q000382:microbiology / Q000473:pathology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index