TY - JOUR
T1 - The spectrum of gastric pathology in portal hypertension—An endoscopic and pathologic study of 550 cases
AU - Ma, Changqing
AU - Chen, Chien Huan
AU - Liu, Ta Chiang
N1 - Publisher Copyright:
© 2016 Elsevier GmbH
PY - 2016/8/1
Y1 - 2016/8/1
N2 - One of the main tasks for pathologists when evaluating gastric biopsies from patients with portal hypertensive gastropathy (PHG) is to examine whether there is increased mucosal vasculature as suggested by endoscopy. However, the full spectrum of pathology findings in patients with portal hypertension (pHTN) is largely unknown. We systematically characterized the endoscopic and pathologic features in gastric biopsies from pHTN patients (study group) and compared with those from patients without pHTN (control group). The study group consisted of 550 consecutive surveillance esophagogastroduodenoscopic (EGD) biopsies, whereas the control group included 281 consecutive EGD biopsies for a variety of indications. As expected, the endoscopic prevalence of PHG was 28%, among which two-thirds showed corresponding histopathologic evidence of increased vasculature. However, non-Helicobacter pylori gastritis was the most common finding in pHTN patients on histology (40%). In addition, hyperplastic polyp was also more common in pHTN patients than in controls (6% vs 3%; P = 0.0314). In contrast, pathology findings of nonspecific reactive changes (29% vs 51%; P < 0.0001), proton pump inhibitor-related changes (16% vs 30%; P < 0.0001), and malignancy (1% vs 3%; P = 0.0138) were less common in pHTN patients. Our results show a spectrum of gastric endoscopic and pathologic findings in pHTN patients. The predominant gastric pathology in pHTN patients may be associated with pHTN-induced gastric microcirculation impairment.
AB - One of the main tasks for pathologists when evaluating gastric biopsies from patients with portal hypertensive gastropathy (PHG) is to examine whether there is increased mucosal vasculature as suggested by endoscopy. However, the full spectrum of pathology findings in patients with portal hypertension (pHTN) is largely unknown. We systematically characterized the endoscopic and pathologic features in gastric biopsies from pHTN patients (study group) and compared with those from patients without pHTN (control group). The study group consisted of 550 consecutive surveillance esophagogastroduodenoscopic (EGD) biopsies, whereas the control group included 281 consecutive EGD biopsies for a variety of indications. As expected, the endoscopic prevalence of PHG was 28%, among which two-thirds showed corresponding histopathologic evidence of increased vasculature. However, non-Helicobacter pylori gastritis was the most common finding in pHTN patients on histology (40%). In addition, hyperplastic polyp was also more common in pHTN patients than in controls (6% vs 3%; P = 0.0314). In contrast, pathology findings of nonspecific reactive changes (29% vs 51%; P < 0.0001), proton pump inhibitor-related changes (16% vs 30%; P < 0.0001), and malignancy (1% vs 3%; P = 0.0138) were less common in pHTN patients. Our results show a spectrum of gastric endoscopic and pathologic findings in pHTN patients. The predominant gastric pathology in pHTN patients may be associated with pHTN-induced gastric microcirculation impairment.
KW - Biopsy
KW - Cirrhosis
KW - Gastric antral vascular ectasia
KW - Non-Helicobacter pylori gastritis
UR - http://www.scopus.com/inward/record.url?scp=84991225996&partnerID=8YFLogxK
U2 - 10.1016/j.prp.2016.05.005
DO - 10.1016/j.prp.2016.05.005
M3 - Article
C2 - 27461830
AN - SCOPUS:84991225996
SN - 0344-0338
VL - 212
SP - 704
EP - 709
JO - Pathology Research and Practice
JF - Pathology Research and Practice
IS - 8
ER -