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'Cardiac-type' (mucinous) mucosa and carditis are both associated with Helicobacter pylori-related gastritis.
Eur J Gastroenterol Hepatol 2004; 16(1):69-74EJ

Abstract

BACKGROUND

Adenocarcinoma of the gastro-oesophageal junction is rapidly increasing in incidence and there is much interest in precursor lesions. The aetiology of inflammation of the gastric cardia (carditis) and the concept of the cardia as a native zone of mucinous gastric glands are disputed.

AIMS

To investigate the relationship between the type of cardiac mucosa and carditis with various histological and clinical parameters.

METHODS

Ninety-eight sets of gastric biopsies (cardia, corpus, incisura and antrum) were obtained prospectively in young patients (median age 40 years) who presented to the outpatient clinic with symptoms of gastro-oesophageal reflux (n = 25) or other upper gastrointestinal symptoms. Patients with neoplasia or Barrett's oesophagus were excluded. The presence (n = 19) or absence of oesophagitis at endoscopy was recorded. The degree of inflammation, Helicobacter pylori density, intestinal metaplasia and atrophy were scored according to the Sydney classification and the type of cardiac mucosa (oxyntic or mucinous) was noted.

RESULTS

We found that carditis and mucinous-type cardiac mucosa were strongly associated with H. pylori-related gastritis (P = 0.00019 and P = 0.006, respectively) but not with clinical or endoscopic gastro-oesophageal reflux. Mucinous mucosa in the cardia was only seen in 17% of biopsies.

CONCLUSION

H. pylori-related gastritis is associated with mucinous-type cardiac mucosa as well as with carditis. The former strongly points to expansion of mucinous cardiac mucosa in H. pylori gastritis. This probably represents metaplasia of oxyntic to mucinous mucosa and raises the possibility of a role in carcinogenesis of the gastro-oesophageal junction.

Authors+Show Affiliations

Department of Pathology, Beaumont Hospital, Dublin, Ireland. cgulmann@rcsi.ieNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15095855

Citation

Gulmann, Christian, et al. "'Cardiac-type' (mucinous) Mucosa and Carditis Are Both Associated With Helicobacter Pylori-related Gastritis." European Journal of Gastroenterology & Hepatology, vol. 16, no. 1, 2004, pp. 69-74.
Gulmann C, Rathore O, Grace A, et al. 'Cardiac-type' (mucinous) mucosa and carditis are both associated with Helicobacter pylori-related gastritis. Eur J Gastroenterol Hepatol. 2004;16(1):69-74.
Gulmann, C., Rathore, O., Grace, A., Hegarty, H., O'Grady, A., Leader, M., ... Kay, E. (2004). 'Cardiac-type' (mucinous) mucosa and carditis are both associated with Helicobacter pylori-related gastritis. European Journal of Gastroenterology & Hepatology, 16(1), pp. 69-74.
Gulmann C, et al. 'Cardiac-type' (mucinous) Mucosa and Carditis Are Both Associated With Helicobacter Pylori-related Gastritis. Eur J Gastroenterol Hepatol. 2004;16(1):69-74. PubMed PMID: 15095855.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 'Cardiac-type' (mucinous) mucosa and carditis are both associated with Helicobacter pylori-related gastritis. AU - Gulmann,Christian, AU - Rathore,Omar, AU - Grace,Antoinette, AU - Hegarty,Helen, AU - O'Grady,Anthony, AU - Leader,Mary, AU - Patchett,Stephen, AU - Kay,Elaine, PY - 2004/4/21/pubmed PY - 2004/7/15/medline PY - 2004/4/21/entrez SP - 69 EP - 74 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 16 IS - 1 N2 - BACKGROUND: Adenocarcinoma of the gastro-oesophageal junction is rapidly increasing in incidence and there is much interest in precursor lesions. The aetiology of inflammation of the gastric cardia (carditis) and the concept of the cardia as a native zone of mucinous gastric glands are disputed. AIMS: To investigate the relationship between the type of cardiac mucosa and carditis with various histological and clinical parameters. METHODS: Ninety-eight sets of gastric biopsies (cardia, corpus, incisura and antrum) were obtained prospectively in young patients (median age 40 years) who presented to the outpatient clinic with symptoms of gastro-oesophageal reflux (n = 25) or other upper gastrointestinal symptoms. Patients with neoplasia or Barrett's oesophagus were excluded. The presence (n = 19) or absence of oesophagitis at endoscopy was recorded. The degree of inflammation, Helicobacter pylori density, intestinal metaplasia and atrophy were scored according to the Sydney classification and the type of cardiac mucosa (oxyntic or mucinous) was noted. RESULTS: We found that carditis and mucinous-type cardiac mucosa were strongly associated with H. pylori-related gastritis (P = 0.00019 and P = 0.006, respectively) but not with clinical or endoscopic gastro-oesophageal reflux. Mucinous mucosa in the cardia was only seen in 17% of biopsies. CONCLUSION: H. pylori-related gastritis is associated with mucinous-type cardiac mucosa as well as with carditis. The former strongly points to expansion of mucinous cardiac mucosa in H. pylori gastritis. This probably represents metaplasia of oxyntic to mucinous mucosa and raises the possibility of a role in carcinogenesis of the gastro-oesophageal junction. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/15095855/'Cardiac_type'__mucinous__mucosa_and_carditis_are_both_associated_with_Helicobacter_pylori_related_gastritis_ L2 - http://Insights.ovid.com/pubmed?pmid=15095855 DB - PRIME DP - Unbound Medicine ER -