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Remnant gastritis should be evaluated histologically rather than endoscopically
Kenichiro Fukuhara1, Harushi Osugi, Shigeru Lee
1Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Hepato-Gastroenterology
|July 23, 2009
Summary
Endoscopic diagnosis of remnant gastritis is unreliable. Histological examination, assessing neutrophil infiltration and cyclooxygenase-2 (COX-2) expression, is crucial for accurate diagnosis and understanding inflammation after distal gastrectomy.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Distal gastrectomy for gastric cancer can lead to remnant gastritis.
- Endoscopic evaluation is the current standard for diagnosing remnant gastritis.
- This study investigates the correlation between endoscopic and histological findings.
Purpose of the Study:
- To correlate endoscopic findings with histological inflammatory markers in remnant gastritis.
- To assess the relationship between neutrophil infiltration, cyclooxygenase-2 (COX-2) expression, and endoscopic diagnosis.
- To determine the optimal method for diagnosing remnant gastritis post-distal gastrectomy.
Main Methods:
- Ninety-seven patients undergoing distal gastrectomy for gastric cancer were studied.
- Endoscopy was performed 12 weeks post-surgery to assess remnant gastritis.
- Histological analysis included neutrophil infiltration scores and COX-2 expression via immunohistochemistry.
Main Results:
- No significant difference in neutrophil infiltration or COX-2 scores between endoscopically positive and negative groups.
- A significant positive correlation was found between neutrophil infiltration and COX-2 expression scores (p<0.001).
Conclusions:
- Endoscopic diagnosis of remnant gastritis does not correlate with histological findings.
- Histological remnant gastritis is significantly correlated with COX-2 expression, indicating inflammation.
- Histological examination is recommended for accurate diagnosis of remnant gastritis.
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