Endoscopy 2021; 53(S 01): S63-S64
DOI: 10.1055/s-0041-1724414
Abstracts | ESGE Days
ESGE Days 2021 Oral presentations
Friday, 26 March 2021 17:00 – 17:45 Precancerous gastric changes: Optimising recognition Room 6

Occurrence of Pseudopyloric Metaplasia in Atrophic Gastritis Patients

G Esposito
1   Sapienza University of Rome, Department of Medical-Surgical Sciences and Translational Medicine, Sant’Andrea Hospital, Rome, Italy
,
E Dilaghi
1   Sapienza University of Rome, Department of Medical-Surgical Sciences and Translational Medicine, Sant’Andrea Hospital, Rome, Italy
,
F Baldaro
1   Sapienza University of Rome, Department of Medical-Surgical Sciences and Translational Medicine, Sant’Andrea Hospital, Rome, Italy
,
E Lahner
1   Sapienza University of Rome, Department of Medical-Surgical Sciences and Translational Medicine, Sant’Andrea Hospital, Rome, Italy
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Aims Pseudopyloric metaplasia (PPM) is a metaplastic transformation resulting in pyloric type glands in the gastric oxyntic mucosa that mainly occurs in atrophic gastritis. Our study aims to assess the occurrence of PPM and clinical and histopathological features in patients corpus atrophic gastritis (CAG).

Methods A cross-sectional study was conducted to assess the occurrence of PPM. A total of 510 (F67.8 %; median age 61 (18-92) years) patients with CAG were included. According to the histopathological assessment (updated Sydney System), the study population was subdivided into three groups: PPM without intestinal metaplasia (IM), IM without PPM and both. CAG patients with PPM and IM and their main characteristics were compared.

Results CAG patients with PPM without IM (PPMgroup) were 116 (22.7 %), those with both (PPM&IMgroup) were 286 (56.1 %), and those with IM without PPM (IMgroup) were 108 (21.2 %). The statically significant differences between the PPM and the IM group as female gender, age<50 years, and iron deficiency and pernicious anemia are shown in [Table 1].

Tab.1

Statically significant differences between the PPM and the IM group at univariate analysis. Data expressed as number (percentage) of the total.

PPMgroup n = 116 (22.7)

IMgroup n = 108 (21.2)

p value

Female

91 (78.4)

66 (61.1)

0.0047

Age <50

45 (38.8)

23 (21.3)

0.0045

Iron deficiency anemia

56 (49.6)

37 (35.2)

0.0331

Pernicious anemia

36 (31.9)

57 (54.3)

0.0008

At multivariate logistic regression, independent factors associated with PPM were age <50 years (OR-2.3 [95 %CI 1.3-4.1]), and absence of pernicious anemia (OR-3.1 [95 %CI 1.8-5.5].

Other features as the presence of autoimmune gastritis and H. pylori positivity were not associated with PPM.

Conclusions Our study showed that in CAG patients PPM alone is as prevalent as IM (about 20 %), but most frequently both types of metaplasia occur together (56 %). Younger age and iron deficiency anemia, the earliest and most frequent micronutrient deficiency in CAG, were both significantly more frequent in CAG patients with PPM without IM. PPM seems to represent the first expression of metaplasia transformation in the chronic inflammatory setting of CAG.

Citation: Esposito G, Dilaghi E, Baldaro F et al. OP157 OCCURRENCE OF PSEUDOPYLORIC METAPLASIA IN ATROPHIC GASTRITIS PATIENTS. Endoscopy 2021; 53: S63.



Publication History

Article published online:
19 March 2021

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