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Intestinal metaplasia in portal hypertensive gastropathy: a frequent pathology

Duygu Ibrişim1, Uğur Cevikbaş, Filiz Akyüz

  • 1Department of Gastroenterohepatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. duygu@ibrisim.net

European Journal of Gastroenterology & Hepatology
|September 17, 2008
PubMed
Abstract

Insights

Intestinal metaplasia (IM) and atrophy are more frequent in patients with portal hypertensive gastropathy (PHG). PHG is a reliable indicator of these gastric mucosal changes.

Area of Science:

  • Gastroenterology
  • Pathology
  • Hepatology

Background:

  • Portal hypertensive gastropathy (PHG) is a common complication in patients with portal hypertension.
  • Intestinal metaplasia (IM) and gastric atrophy are significant histopathological findings with potential implications for gastric cancer risk.

Purpose of the Study:

  • To investigate the prevalence of intestinal metaplasia (IM) in patients diagnosed with portal hypertensive gastropathy (PHG).
  • To compare the frequency of IM in PHG patients against a control group with functional dyspepsia.
  • To assess the correlation between PHG severity and IM, as well as identify independent predictors for IM and atrophy.

Main Methods:

  • Prospective evaluation of 289 patients across three groups: controls (functional dyspepsia), cirrhotics, and non-cirrhotic portal hypertensives.
  • Histological examination of gastric mucosal biopsies (antrum, angulus, corpus) for atrophy, IM, dysplasia, Helicobacter pylori (Hp), and PHG.
  • Statistical analysis including comparison between groups and multivariate analysis to identify independent predictors.

Main Results:

  • Intestinal metaplasia (IM) was significantly more frequent in patients with PHG compared to controls (P<0.05) and correlated with PHG severity.
  • Gastric atrophy was also more prevalent in cirrhotic patients than in controls (P<0.05).
  • Helicobacter pylori (Hp) prevalence was higher in the control group and positively correlated with atrophy, while PHG and age were independent predictors for IM.

Conclusions:

  • Higher frequencies of gastric atrophy and IM are observed in patients with PHG.
  • PHG serves as a reliable indicator for the presence of IM and atrophy in the gastric mucosa.
  • These findings highlight the importance of evaluating gastric histology in patients with PHG.

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