Changes of Gastric Juice Microenvironment in Patients with Fundic Gland Polyp and Hyperplastic Polyp

Pathobiology ◽  
2021 ◽  
pp. 1-9
Author(s):  
He Gao ◽  
Lili Chang ◽  
Limin Wang ◽  
Xiaona Zhou ◽  
Ning Wang
Keyword(s):  
Gastric Juice ◽  
Hyperplastic Polyp ◽  
Bile Reflux ◽  
Pathological Examination ◽  
Control Group ◽  
Fundic Gland ◽  
Fundic Gland Polyp ◽  
Fundic Gland Polyps ◽  
Potential Risk Factors ◽  
H Pylori

<b><i>Introduction:</i></b> The aim of this study was to study the relationship between the formation of gastric fundic gland polyp and gastric hyperplastic polyp (HP) and the changes of gastric juice microenvironment. <b><i>Methods:</i></b> The proton-pump inhibitor (PPI) applications to patients were recorded. Gastric juices and biopsy polyps were collected for pathological examination, <i>H. pylori</i> tests, biomarkers, and <i>MUC1</i>, <i>MUC2</i>, <i>MUC5AC expression</i> measurement. <b><i>Results:</i></b> Among 34,892 patients, the detection rate of gastric fundic gland polyps was significantly higher than that of gastric HPs (<i>p</i> &#x3c; 0.01). The incidence rate of gastric fundic gland polyp and gastric HP in PPI users (<i>n</i> = 3,886) was higher than that of non-PPI users (<i>p</i> &#x3c; 0.01). The occurrence of polyp was positively related to the duration of PPI application and the <i>H. pylori</i>-positive rate. The bile reflux rate between fundic gland polys group (17.61%) and HPs (28.67%) was significantly different (<i>p</i> &#x3c; 0.01). The levels of gastric juice Gastrin-17, epidermal growth factor (EGF) and MUC<sub>2</sub> from patients with gastric fundic gland polyps and gastric HPs were higher than those in the control group (<i>p</i> &#x3c; 0.01). However, patients with gastric fundic gland polyps and HPs had significantly lower gastric juice PGE<sub>2</sub> and MUC5AC (<i>p</i> &#x3c; 0.01). <b><i>Conclusion:</i></b> PPI application, <i>H. pylori</i> infection, and bile reflux are the potential risk factors for formation of fundic gland polyps and HPs. The potential mechanism of polyps’ formation can be related to the levels of Gastrin-17, EGF, MUC<sub>2</sub>, PGE<sub>2</sub>, and MUC5AC in gastric juice.

A new understanding of the H. pylori eradication mechanism

2019 ◽  
Author(s):  
Shanshan Su ◽  
Guo-qi Zheng ◽  
Ying-ying Liu ◽  
Yu-fei Liang ◽  
Hui Song ◽  
...  
Keyword(s):  
Gastric Juice ◽  
Intervention Group ◽  
Control Group ◽  
Rapid Urease Test ◽  
Mucus Layer ◽  
Culture Methods ◽  
Detection Rates ◽  
Urease Test ◽  
Gastric Lumen ◽  
H Pylori

Abstract Background: Helicobacter pylori (H. pylori) cannot usually be detected in the gastric juice and it is thought that H. pylori may be implanted under the mucus layer for long term. The mechanisms of action of proton pump inhibitor (PPI), antibiotics, and bismuth for H. pylori eradication are not entirely clear. Our study aimed to determine the role of PPI on the movement of H. pylori across the mucus layer to the gastric lumen and the mechanism of PPI, antibiotics, and bismuth on H. pylori eradication. Methods: Patients with H. pylori infection were intravenous injected with PPI (intervention group, n=31) or without PPI (control group, n=37). The presence of H. pylori in the gastric juice was evaluated by the rapid urease test (RUT), polymerase chain reaction (PCR), and culture methods. Results: The H. pylori positive detection rates were all significantly higher among patients in the intervention group than among patients in the control group by the RUT (P < 0.0001), PCR (P < 0.0001), and culturing (P = 0.0386). Conclusion: H. pylori can penetrate across the mucus layer to the gastric lumen following PPI intervention. The direct antimicrobial activity of PPI might because of diminished numbers of H. pylori due to probiotics in the gastric lumen. Antibiotics and bismuth might play a local sterilization role in the gastric lumen when H. pylori penetrate across the mucus layer.

scholarly journals Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies

2007 ◽  
Vol 44 (1) ◽  
pp. 14-17 ◽  
Author(s):  
Drausio Jefferson Morais ◽  
Ademar Yamanaka ◽  
José Murilo Robilotta Zeitune ◽  
Nelson Adami Andreollo
Keyword(s):  
Hyperplastic Polyp ◽  
Gastric Polyp ◽  
Adenomatous Polyps ◽  
Fundic Gland ◽  
Digestive Endoscopy ◽  
Gastric Lesions ◽  
Hyperplastic Polyps ◽  
Gastric Polyps ◽  
Fundic Gland Polyps ◽  
Upper Digestive Endoscopy

BACKGROUND: Gastric polyps are small gastric lesions, asymptomatic in most cases and are generally discovered inadvertently during upper digestive endoscopy. AIM: To retrospectively review the characteristics and frequency of gastric polyps, derived from the gastric mucosal epithelium in a large series of endoscopies. METHODS: One hundred and fifty three patients in a series of 26,000 consecutive upper digestive endoscopies done over a 5-year period, being that each patient had only one examination were analyzed and their histological and Yamada classification, as well as their location, size, histopathological findings and treatment studied. All patients had at least one gastric polyp, as confirmed by histological examination. RESULTS: The polyps were classified as hyperplastic, adenomatous and fundic gland polyps. The most of them measure less than 1 cm (hyperplastic polyps - 60,5%; adenomatous polyps - 73,6%; fundic gland polyps - 72%). Hyperplastic polyps were the most frequent and accounted for 71.3% of the cases, whereas fundic gland polyps accounted for 16.3% and adenomatous polyps for 12.4%. Hyperplastic and adenomatous polyps were primarily single, whereas fundic gland polyps tended to be multiple. A carcinoma was detected in one hyperplastic polyp (0.9%) and in two adenomatous polyps (10.5%). High grade dysplastic foci were found in four adenomatous polyps (21%). CONCLUSIONS: The digestive endoscopy is the safest and efficient method for the diagnosis of the gastric polyps, that in most of the patients does not show characteristic symptoms. The histopathological definition is not possible to the endoscopic glance being needed the pathologist's aid, once the conduct to be adopted will depend on the result of the biopsy.

scholarly journals Effect of Monotherapy Weifuchun Tablets on Chronic Atropic Gastritis: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Jiamin He ◽  
Weiyi Shen ◽  
Yawen Zhang ◽  
Mengjia Hu ◽  
Yanfei Fang ◽  
...  
Keyword(s):  
Folic Acid ◽  
Atrophic Gastritis ◽  
Chronic Atrophic Gastritis ◽  
Pathological Response ◽  
Pathological Examination ◽  
Control Group ◽  
Gastric Disease ◽  
Traditional Chinese Medicines ◽  
Chinese Medicines ◽  
H Pylori

Abstract Background and Aim: Chronic atrophic gastritis is a common gastric disease which shows a positive correlation with the occurrence of gastric cancer. Traditional chinese medicines have been used in the treatment of chronic atrophic gastritis. There is no solid evidence for the curative effects of traditional chinese medicines. This study aimed to investigate the clinical efficacy of Weifuchun tablets on patients with chronic atrophic gastritis. Methods 97 patients of chronic atrophic gastritis without current H. pylori infection were divided into two groups: an experiment group treated with Weifuchun and a control group treated with teprenone and folic acid for six months. Pathological examination of gastric biopsies and clinical symptoms assessment were performed for all patients before and after treatments. Primary outcome was the pathological response rate in each group evaluated by changes of histological scores.Secondary outcome was the clinical symptom scores. Results Twenty four patients in the Weifuchun group and twenty eight patients in the control group completed the study. The pathological response rates for atrophy and intestinal metaplasia were 66.7% and 45.8% in the Weifuchun group and 66.7% and 42.9% in the folic acid group, respectively, without statistical significance between groups.Clinical symptoms failed to improve after treatments in either group. Conclusions Weifuchun is effective to improve pathological changes of chronic atrophic gastritis in patients without current H. pylori infection. Monotherapy of Weifuchun had a similar efficacy to the combined therapy by teprenone and folic acid in the treatment of chronic atrophic gastritis. Trial registration: Evaluation of Weifuchun Pills on chronic atrophic gastritis, ChiCTR-IPR-17013939, Registered 15 December 2017, http://www.chictr.org.cn/ showproj.aspx?proj = 23910.

scholarly journals Effect of proton pump inhibitor on the movement of Helicobacter pylori across the mucus layer to the gastric lumen

2019 ◽  
Author(s):  
shanshan Su(Former Corresponding Author) ◽  
Guo-qi Zheng(New Corresponding Author) ◽  
Ying-ying Liu ◽  
Yu-fei Liang ◽  
Hui Song ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Gastric Juice ◽  
Proton Pump ◽  
Intervention Group ◽  
Control Group ◽  
Mucus Layer ◽  
Urease Test ◽  
Gastric Lumen ◽  
H Pylori

Abstract Background: Helicobacter pylori ( H. pylori ) cannot usually be detected in the gastric juice and it is thought that H. pylori may reside under the mucus layer for long term. The mechanisms of action of proton pump inhibitor (PPI)for H. pylori eradication are not entirely clear. Our study aimed to determine the role of PPI on the movement of H. pylori across the mucus layer to the gastric lumen and the mechanism of PPI on H. pylori eradication. Methods: Patients with H. pylori infection were intravenous injected with PPI (intervention group, n=31) or without PPI (control group, n=37). The presence of H. pylori in the gastric juice was evaluated by the rapid urease test (RUT), polymerase chain reaction (PCR), and culture methods. Results: The H. pylori positive detection rates were all significantly higher among patients in the intervention group than among patients in the control group by the RUT ( P < 0.0001), PCR ( P < 0.0001), and culturing ( P = 0.0386). Conclusion: H. pylori can penetrate across the mucus layer to the gastric lumen following PPI intervention, and thus it might represent a novel target in the eradication of H. pylori .

scholarly journals CONVENTIONAL VIDEOENDOSCOPY CAN IDENTIFY HELICOBACTER PYLORI GASTRITIS?

2016 ◽  
Vol 29 (2) ◽  
pp. 73-76 ◽  
Author(s):  
Alexandre GOMES ◽  
Thelma Larocca SKARE ◽  
Manoel Alberto PRESTES ◽  
Maiza da Silva COSTA ◽  
Roberta Dombroski Petisco ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
The Body ◽  
Gastric Body ◽  
Rapid Urease Test ◽  
Fundic Gland ◽  
Antral Mucosa ◽  
Exclusion Criteria ◽  
Fundic Gland Polyps ◽  
Urease Test ◽  
H Pylori

ABSTRACT Background: Studies with latest technologies such as endoscopy with magnification and chromoendoscopy showed that various endoscopic aspects are clearly related to infection by Helicobacter pylori (HP). The description of different patterns of erythema in gastric body under magnification of images revived interest in identifying these patterns by standard endoscopy. Aim: To validate the morphologic features of gastric mucosa related to H. pylori infection gastritis allowing predictability of their diagnosis as well as proper targeting biopsies. Methods: Prospective study of 339 consecutive patients with the standard videoendoscope image analysis were obtained, recorded and stored in a program database. These images were studied with respect to the presence or absence of H. pylori, diagnosed by rapid urease test and/or by histological analysis. Were studied: a) normal mucosa appearance; b) mucosal nodularity; c) diffuse nonspecific erythema or redness (with or without edema of folds and exudate) of antrum and body; d) mosaic pattern with focal area of hyperemia; e) erythema in streaks or bands (red streak); f) elevated (raised) erosion; g) flat erosions; h) fundic gland polyps. The main exclusion criteria were the use of drugs, HP pre-treatment and other entities that could affect results. Results: Applying the exclusion criteria, were included 170 of the 339 patients, of which 52 (30.58%) were positive for HP and 118 negative. On the positive findings, the most associated with infection were: nodularity in the antrum (26.92%); presence of raised erosion (15.38%) and mosaic mucosa in the body (21.15%). On the negative group the normal appearance of the mucosa was 66.94%; erythema in streaks or bands in 9.32%; flat erosions 11.86%; and fundic gland polyps 11.86%. Conclusion: Endoscopic findings are useful in the predictability of the result and in directing biopsies. The most representative form of HP related gastritis was the nodularity of the antral mucosa. The raised erosion and mucosa in mosaic in the body are suggestive but not specific to the infection. The other forms were not conclusive of the presence of HP.

scholarly journals Feasibility of Plasma-Methylated SFRP2 for Early Detection of Gastric Cancer

2020 ◽  
Vol 27 (2) ◽  
pp. 107327482092255 ◽  
Author(s):  
Jin Miao ◽  
Yi Liu ◽  
Guodong Zhao ◽  
Xiaoyu Liu ◽  
Yong Ma ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Intestinal Metaplasia ◽  
Hyperplastic Polyp ◽  
Screening Method ◽  
Noninvasive Detection ◽  
Fundic Gland ◽  
Gastric Intestinal Metaplasia ◽  
Fundic Gland Polyp ◽  
Serum Cea ◽  
Higher Sensitivity

Gastric cancer (GC) is fifth most frequently diagnosed cancer and second leading cause of cancer in China. More than 80% of GC are diagnosed at an advanced stage due to low uptake rate of invasive screening method. The performance of methylated SFRP2 test was evaluated in 236 plasma samples, including 92 patients with GC, 16 intestinal metaplasia patients, 26 gastric fundic gland polyp patients, 13 small adenoma patients, 39 hyperplastic polyp patients, and 50 control patients. The sensitivity of plasma methylated SFRP2 was compared to serum CEA, CA72-4, CA19-9, and CA242 results in 79 patients with GC. The sensitivities for detecting GC and gastric intestinal metaplasia by methylated SFRP2 test were 60.9% and 56.3% with a specificity of 86.0%. Methylated SFRP2 test had significantly higher positive detection rate for patients with GC than gastric fundic gland polyp, small adenoma, and hyperplastic polyp patients. In 79 patients with GC, the sensitivities of CEA, CA72-4, CA19-9, and CA242 for detecting GC were 22.8%, 16.5%, 12.7%, and 11.4%. In comparison, the sensitivity of methylated SFRP2 test for detecting GC was 58.2%. Plasma methylated SFRP2 test may become a valuable tool for the noninvasive detection of GC and precursor lesions and showed higher sensitivity than serum tumor markers.

scholarly journals The Effect of Primary Duodenogastric Bile Reflux on the Presence and Density of Helicobacter pylori and on Gastritis in Childhood

Medicina ◽  
2019 ◽  
Vol 55 (12) ◽  
pp. 775
Author(s):  
Mehmet Agin ◽  
Yusuf Kayar
Keyword(s):  
Helicobacter Pylori ◽  
Bile Reflux ◽  
Duodenogastric Reflux ◽  
Control Group ◽  
Pediatric Age Group ◽  
Study Results ◽  
H Pylori ◽  
Reported Data ◽  
The Relationship ◽  
Upper Gastrointestinal

Background and Objectives: Although there are many studies that investigate the relationship between duodenogastric reflux (DGR) and Helicobacter pylori in adult patients, the reported data are contradictory. In addition, there are very few studies in the literature investigating the relationship between DGR and H. pylori in the pediatric age group. In the present study, we investigated the effect of primary DGR on H. pylori and gastritis. Materials and Methods: A total of 361 patients who were referred to the clinic of our hospital with dyspeptic complaints who had an upper gastrointestinal system endoscopy and a gastric biopsy were included in the study. Results: DGR was detected in 45 cases, and 316 cases that did not have DGR were considered as the control group. Comparisons were made between the DGR cases and the control group in terms of risk factors (age, gender), the presence and density of H. pylori, and the presence and severity of gastritis. The average age of the patients who were included in the study was 11.6 ± 4.6 years. A total of 128 (36%) of the cases were male and 233 (64%) were female. DGR was present in 45 (13%) of the cases. The average age of the patients with DGR was 13.9 ± 3.1 years, the average age of the control group was 11.3 ± 4.7, and there were statistically significant differences (p < 0.001). No significant differences were detected in terms of gender between DGR and the control group (p > 0.05). H. pylori (+) was detected in 29 (64%) of patients with DGR, and in 202 (64%) of the control group. No significant differences were detected between H. pylori prevalence (p = 0.947). Gastritis was detected in 37 (82%) of the patients with DGR, and in 245 (77%) of the control group (p = 0.476). No significant differences were detected between the presence and density of H. pylori, gastritis presence, severity and DGR (p > 0.05). Conclusions: The ages of patients with DGR were significantly higher than in the control group, and advanced age was shown to be a risk factor for primary DGR. It was found that the presence of DGR has no effect on the presence and severity of H. pylori. Given this situation, we consider it is important to eradicate H. pylori infection, especially in the case where H. pylori is present together with DGR.

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