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Histological changes associated with pyloric and pseudopyloric metaplasia after Helicobacter pylori eradication

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Abstract

Pyloric metaplasia (PM) and pseudopyloric metaplasia (PPM) are metaplastic changes resulting in pyloric-type glands in the gastric oxyntic mucosa that mainly occur in chronic gastritis caused by Helicobacter pylori (H. pylori) infection. Focusing on PM and PPM, we classified the histological changes in gastric mucosa according to the Updated Sydney System, using 314 biopsy specimens of gastric greater curvature of the middle body before H. pylori eradication (HPE). Next, the numbers of PM and PPM glands were counted in 47 specimens, and subjects were followed up over 10 years after HPE. PPM was recognized jointly with inflammation, activity, atrophy, and intestinal metaplasia, but PM was recognized more frequently than PPM as atrophy and intestinal metaplasia progressed. Both PM and PPM regressed significantly within 6 years after HPE. Additionally, we demonstrated that PM and PPM are not always coincident with spasmolytic polypeptide-expressing metaplasia (SPEM). In conclusion, PM and PPM are considered different modulations of the same line of differentiation, which are both reversible, with PM potentially emerging from PPM upon progression.

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Acknowledgments

Sincere thanks are due to Dr. Ken-ichi Mukaisho of Department of Pathology, Faculty of Medicine, Shiga University of Medical Science, who revised the work. We also thank Mrs. Yoko Kudo and Mrs. Kanako Ito for help with immunohistochemical staining.

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Authors and Affiliations

  1. Department of Gastroenterology, Faculty of Medicine, Oita University, Yufu, Oita, 879-5593, Japan

    Yasuhiro Wada, Masaaki Kodama, Masahide Fukuda, Kensuke Fukuda, Kazuhisa Okamoto, Ryo Ogawa, Kazuhiro Mizukami, Tadayoshi Okimoto & Kazunari Murakami

  2. Department of Pathology, Faculty of Medicine, Shiga University of medical science, Otsu, Shiga, 525-2192, Japan

    Yasuhiro Wada & Ryoji Kushima

Authors
  1. Yasuhiro Wada
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  2. Ryoji Kushima
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  3. Masaaki Kodama
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  4. Masahide Fukuda
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  5. Kensuke Fukuda
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  6. Kazuhisa Okamoto
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  8. Kazuhiro Mizukami
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  10. Kazunari Murakami
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Contributions

Yasuhiro Wada contributed to design work, data analysis, and manuscript writing; Ryoji Kushima contributed to the conception of the work, revised the work and approved the final version manuscript; Masaaki Kodama contributed to design work, data analysis, and manuscript writing; Masahide Fukuda contributed to acquisition of data; Kensuke Fukuda contributed to acquisition of data; Kazuhisa Okamoto contributed to acquisition of data; Ryo Ogawa contributed to acquisition of data; Kazuhiro Mizukami contributed to acquisition of data; Tadayoshi Okimoto contributed to acquisition of data; Kazunari Murakami contributed to the conception of the work and critically revised it.

Corresponding author

Correspondence to Ryoji Kushima.

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The appropriate Ethical Committee approved the collection of the specimens included in this study, and informed consent was obtained from all participants.

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The authors declare that they have no conflict of interest.

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Wada, Y., Kushima, R., Kodama, M. et al. Histological changes associated with pyloric and pseudopyloric metaplasia after Helicobacter pylori eradication. Virchows Arch 477, 489–496 (2020). https://doi.org/10.1007/s00428-020-02805-9

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  • DOI: https://doi.org/10.1007/s00428-020-02805-9

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