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Particular Morphological Features in the Diagnosis of Pediatric Helicobacter pylori Gastritis: A Morphometry-Based
Ana-Maria Teodora Domșa1, Dan Gheban1,2, Camelia Lazăr1
1Department of Pathology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Insights
Foveolar hyperplasia (FH) is a significant indicator of Helicobacter pylori (H. pylori) infection in children. This study found FH is associated with H. pylori, showing changes in gastric mucosa structure.
Area of Science:
- Pediatric Gastroenterology
- Histopathology
- Infectious Diseases
Background:
- Pediatric gastritis assessment relies on the Updated Sydney Classification for H. pylori.
- H. pylori infection is a common cause of gastritis in children.
- Morphometric analysis aids in understanding histological changes.
Purpose of the Study:
- To investigate morphometric alterations in the antral mucosa of children with H. pylori infection.
- To assess the relationship between H. pylori density, inflammation, and mucosal changes.
- To evaluate the significance of foveolar hyperplasia (FH) in pediatric H. pylori gastropathy.
Main Methods:
- Analysis of 65 pediatric gastric biopsy cases.
- Scoring biopsies using the Updated Sydney Classification.
- Quantitative morphometric measurements including mucosal thickness, foveolar and glandular length, glandular diameter, and inter-glandular distance.
- Assessment of foveolar hyperplasia (FH).
Main Results:
- Antral mucosal thickness correlated positively with H. pylori bacterial density and inflammation intensity (p < 0.05).
- Foveolar hyperplasia (FH) was strongly associated with H. pylori presence (p < 0.001).
- FH correlated with increased foveolar/glandular length and glandular diameter (p < 0.05) but not mucosal thickness.
Conclusions:
- Foveolar hyperplasia (FH) is a key histological feature of pediatric gastropathy.
- FH is a significant finding in H. pylori infection among children.
- FH should be considered in the histopathological reporting of pediatric gastric biopsies.
Background:
Current pediatric guidelines recommend the use of the Updated Sydney Classification for gastritis to assess histological changes caused by Helicobacter pylori (H. pylori) infection. The purpose of this study was to investigate the morphometric alterations of the antral mucosa in relation to pediatric H. pylori infection.
Methods:
A total of 65 cases were considered eligible. Apart from scoring the biopsies according to the recommendations, foveolar hyperplasia (FH) was assessed. The following measurements were performed on digital slides: total mucosal thickness, foveolar and glandular length, number of glandular cross sections per 40X field, glandular diameter, and distance between glands.
Results:
The thickness of the antral mucosa increased along with the bacterial density and the intensity of inflammation in H. pylori-infected children (p < 0.05). FH was significantly associated with the presence of H. pylori (p < 0.001) and also exhibited a greater length of the foveolar and glandular structures and an increased glandular diameter (p < 0.05), but without influencing the thickness of the mucosa.
Conclusions:
Our results reinforce the fact that FH is not only an important histologic characteristic of gastropathy, but is also a significant change observed in H. pylori infection in children and may be considered for reporting when evaluating pediatric gastric biopsies.
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