title: Distinct metaplastic and inflammatory phenotypes in autoimmune and adenocarcinoma-associated chronic atrophic gastritis.
abstract: BACKGROUND
  Autoimmune gastritis (AIG) and adenocarcinoma-associated chronic atrophic gastritis (CAG) are both associated with oxyntic atrophy, but AIG patients demonstrate an increased risk of carcinoid tumors rather than the elevated risk of adenocarcinoma observed with CAG. We therefore sought to compare the characteristics of the metaplastic mucosa in AIG and CAG patients.
  
  
  METHODS
  We examined markers for metaplasia (spasmolytic polypeptide expressing metaplasia (SPEM) and intestinal metaplasia) as well as proliferation (Ki67) and immune cell populations (neutrophils, macrophages, and eosinophils) in gastric sections from 16 female patients with autoimmune thyroiditis and AIG and 17 patients with CAG associated with gastric adenocarcinoma.
  
  
  RESULTS
  Both AIG and CAG patients demonstrated prominent SPEM and intestinal metaplasia. However, AIG patients displayed significantly lower numbers of infiltrating macrophages and significantly reduced mucosal cell proliferation as compared to CAG patients.
  
  
  CONCLUSIONS
  These findings indicate that, while both AIG and CAG patients display prominent oxyntic atrophy and metaplasia, the AIG patients do not show proliferative metaplastic lineages that would predispose to adenocarcinoma.
authors.affiliation: Department of Surgery, Vanderbilt University School of Medicine, USA; Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, USA; Department of Surgery of Postgraduate School of Medicine, Gyeongsang National University, South Korea.
authors.forename: Sangho
authors.initials: S
authors.lastname: Jeong
authors.affiliation: Department of Surgery, Vanderbilt University School of Medicine, USA.
authors.forename: Eunyoung
authors.initials: E
authors.lastname: Choi
authors.affiliation: Department of Surgery, Vanderbilt University School of Medicine, USA; Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, USA.
authors.forename: Christine P
authors.initials: CP
authors.lastname: Petersen
authors.affiliation: Department of Surgery, Vanderbilt University School of Medicine, USA; Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, USA.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Roland
authors.affiliation: Department of Internal Medicine-Gastroenterology, Second University of Naples, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Federico
authors.affiliation: Department of Pathology, Federico II University, Italy.
authors.forename: Rossana
authors.initials: R
authors.lastname: Ippolito
authors.affiliation: Department of Pathology, Federico II University, Italy.
authors.forename: Francesco P
authors.initials: FP
authors.lastname: D'Armiento
authors.affiliation: Department of Medicine-Gastroenterology, Federico II University, Naples, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Nardone
authors.affiliation: Division of Gene Regulation, Keio University, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nagano
authors.affiliation: Division of Gene Regulation, Keio University, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Saya
authors.affiliation: Department of Internal Medicine-Gastroenterology, Second University of Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Romano
authors.affiliation: Department of Surgery, Vanderbilt University School of Medicine, USA; Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, USA; Nashville VA Medical Center, Vanderbilt University School of Medicine, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Goldenring
keywords: CD44 variant 9; DMBT1; Spasmolytic polypeptide-expressing metaplasia; gastritis; intestinal metaplasia; macrophage; neutrophil