ENDOCRINE CELL GROWTHS IN ATROPHIC BODY GASTRITIS - CRITICAL-EVALUATION OF A HISTOLOGICAL CLASSIFICATION

The aim of the present study was to evaluate the correspondence of the classification of non-antral endocrine cell growths proposed by Solci a and co-workers with clinical features and non-endocrine mucosal chan ges. For this purpose, 94 cases of newly diagnosed atrophic body gastr itis were investigated using endoscopic biopsies and compared with 18 control subjects. The patients were subdivided into the following four groups according to the most severe pattern of endocrine cell prolife ration found in the body mucosa, as shown by chromogranin A immunostai ning: group 1, normal pattern (7 cases, 7.5 per cent); group 2, simple hyperplasia (6 cases, 6.5 per cent); group 3, linear hyperplasia (24 cases, 25.8 per cent); group 4; micronodular hyperplasia (56 cases, 60 .2 per cent). Adenomatoid hyperplasia was found in only one case, thus precluding further analysis. Patients in groups I and 2 had lower aci d secretion, higher gastrin level, and higher mean scores in all histo pathological variables of chronic gastritis considered by the Sydney s ystem when compared with controls, but did not differ among them in an y parameter investigated. When compared with groups 1 and 2, patients of groups 3 and 4 showed higher values of circulating gastrin, higher scores of glandular atrophy, and lower values of acid secretion and of mononuclear and neutrophil inflammatory cell infiltration. Moreover, group 4 patients differed significantly from those of group 3 in their higher gastrin levels and atrophy scores, and lower scores of neutrop hil cell infiltration. On the basis of these results, it is proposed t hat for practical purposes the normal and the simple hyperplasia patte rns may be incorporated into a single group. It is concluded that this classification in its simplified form, based on a qualitative histolo gical approach, shows clinical relevance without the need to perform e xpensive, time-consuming morphometric evaluations. (C) 1997 by John Wi ley & Sons, Ltd.