FOVEOLAR HYPERPLASIA FOLLOWING PARTIAL GASTRECTOMY RESULTS FROM EXPANSION OF SURFACE MUCOUS CELL COMPARTMENT

Antrectomy with gastroenterostomy reconstruction is often associated w ith the development of foveolar hyperplasia and oxyntic atrophy. While a role for bile reflux in the etiology of foveolar hyperplasia is wel l established, the identity of the mucous cell lineages responsible fo r this condition have not been well characterized. We have studied thr ee patients who demonstrated foveolar hyperplasia in their gastric rem nant following antrectomy and gastroenterostomy. Mucosal samples were stained with antibodies against the trefoil peptides pS2 and hSP, to i dentify surface mucous and mucous neck cell lineages, respectively. Po stoperative biopsies from all three patients showed oxyntic atrophy as documented by staining of parietal cells with antibodies against H/K- ATPase. All three patients demonstrated an exclusive expansion of pS2 immunoreactive mucous cells. The hSP staining cells were located deep in the expanded foveolar region. The results suggest that foveolar hyp erplasia following antrectomy with gastroenterostomy results from a re active hyperplasia of surface mucous cells. This pattern of surface ce ll hyperplasia is more consistent with a reactive expansion of mucous cells than with a response to chronic injury.