1911

The frequency of nodular gastritis in adult patients and the relation of this type of gastritis with Helicobacter pylori and histopathologic findings

Objectives: Endoscopic nodular gastritis is usually used to describe the miliary nodular appearance of thegastric mucosa during endoscopy. Recent studies have shown that nodular gastritis is closely related toHelicobacter pylori (H. pylori) infection and may cause stomach cancer, especially in young women. We aimedto determine the frequency of nodüler gastritis in this study, other lesions seen during endoscopy, H. pylorifrequency and histopathological findings.Methods: Adult patients who underwent endoscopy between March 2015 and April 2017 were identified.Medical records of patients; demographic characteristics, endoscopic features and pathologic were investigatedretrospectively. Patients with nodular gastritis were compared with age and gender matched control group.Results: Of the 1877 patients evaluated, 39 patients with endoscopic nodular gastritis and 72 as control groupwere enrolled. The prevalence of H. pylori infection was significantly higher in patients with endoscopic nodulargastritis than in the control group (74.35% versus 63.88, p < 0.0001). The most common concurrent endoscopicfindings were erosions (25.64%). Histopathologically, the prevalence of atrophic gastritis and intestinalmetaplasia in the patients with endoscopic nodular gastritis was also higher than in the control group (p < 0.05).Conclusions: Nodular gastritis is often caused by chronic H. pylori infection. It is observed more frequentlyin women and children. Most patients with H. pylori infection have no specific symptom or complication, butsome patients may develop premalign conditions such as active gastritis, atrophic gastritis and intestinalmetaplasia. For this reason, H. pylori eradication in patients with nodular gastritis may reduce the developmentof peptic ulcer and possibly gastric malignancy.

PDF

___

[1] Graham DY. Helicobacter pylori update: gastric cancer, reliable therapy, and possible benefits. Gastroenterology 2015;148:719-31.e3.
[2] Correa P, Piazuelo MB. The gastric precancerous cascade. J Dig Dis 2012;13:2-9.
[3] Hassall E, Dimmick JE. Unique features of Helicobacter pylori disease in children. Dig Dis Sci 1991;36:417-23.
[4] De Giacomo C, Fiocca R, Villani, Listo L, Licardi G, Diegoli N. Helicobacter pylori infection and chronic gastritis: clinical, serological, and histologic correlations in children treated with amoxicillin and colloidal bismuth subcitrate. J Pediatr Gastroenterol Nutr 1990;11:310-6.
[5] Kamada T, Tanaka A, Yamanaka Y, Manabe N, Kusunoki H, Miyamoto M, et al. Nodular gastritis with Helicobacter pylori infection is strongly associated with diffuse-type gastric cancer in young patients. Dig Endosc 2007;19:180-4.
[6] Chen MJ, Wang TE, Chang WH, Liao TC, Lin CC, Shih SC. Nodular gastritis: an endoscopic indicator of Helicobacter pylori infection. Dig Dis Sci 2007;52:2662-6.
[7] Miyamoto M, Haruma K, Yoshihara M, Hiyama T, Sumioka M, Nishisaka T, et al. Nodular gastritis in adults is caused by Helicobacter pylori infection. Dig Dis Sci 2003;48:968-75.
[8] Önal İK, Sökmensüer C, Demir Önal E, Ersoy O, Yeniova Ö, Aydınlı M, et al. Clinical and pathological features of nodular gastritis in adults. Turk J Med Sci 2009;39:719-23.
[9] Maghidman S, Cok J, Bussalleu A. Histopathological findings in nodular gastritis. Experience at the Cayetano Heredia National Hospital. Rev Gastroenterol Peru 2001;21:261-70.
[10] Nakashima R, Nagata N, Watanabe K, Kobayakawa M, Sakurai T, Akiyama J. Histological features of nodular gastritis and its endoscopic classification. J Dig Dis 2011;12:436-42.
[11] Kusters JG, van Villet AH, Kuipers EJ: Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev 2006;19:449- 90.
[12] Kato S, Yoshikazu N, Kyoko O, Konno M, Shun-ichi M, Toyoda S, et al. The prevalence of Helicobacter pylori in Japanese children with gastritis or peptic ulcer disease. J Gastroenterol 2004;39:734-8.
[13] Bahu Mda G, da Silveira TR, Maguilnick I, UlbrichKulczynski J. Endoscopic nodular gastritis: an endoscopic indicator of high-grade bacterial colonization and severe gastritis in children with Helicobacter pylori. J Pediatr Gastroenterol Nutr 2003;36: 217-22.
[14] Sokmensuer C, Onal IK, Yeniova O, Ersoy O, Aydinli M, Yonem O, et al. What are the clinical implications of nodular gastritis? Clues from histopathology. Dig Dis Sci 2009;54:2150- 4.
[15] Rafeey M, Jafari Rouhi AH, Gassemi BA, Rouhi AJ. Relationship between endoscopic nodular gastritis and Helicobacter pylori infection in children. Indian J Gastroenterol 2004;23:138-9.
[16] Niknam R, Manafi A, Maghbool M, Kouhpayeh A, Mahmoudi L. Is endoscopic nodular gastritis associated with premalignant lesions? Neth J Med 2015;73:236-41.
[17] Chen MJ, Shih SC, Wang TE, Chan YJ, Chen CJ, Chang WH. Endoscopic patterns and histopathological features after eradication therapy in Helicobacter pylori-associated nodular gastritis. Dig Dis Sci 2008;53:1893-7.
[18] Konturek PC, Konturek SJ, Brzozowski T. Helicobacter pylori infection in gastric cancerogenesis. J Physiol Pharmacol 2009;60:3-21.
[19] Nardone G, Rocco A, Malfertheiner P. Review article: Helicobacter pylori and molecular events in precancerous gastric lesions. Aliment Pharmacol Ther 2004;20:261-70.