The spectrum of gastric pathology in portal hypertension—An endoscopic and pathologic study of 550 cases

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• 作者：Changqing Ma^a ; ¹ ; ^{mac2@upmc.edu" class="auth_mail" title="E-mail the corresponding author} ; Chien-Huan Chen^b ; Ta-Chiang Liu^a ; ^{tliu@path.wustl.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Cirrhosis ; Biopsy ; Non-Helicobacter pylori gastritis ; Gastric antral vascular ectasia
• 刊名：Pathology - Research and Practice
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：212
• 期：8
• 页码：704-709
• 全文大小：1926 K

文摘

One of the main tasks for pathologists when evaluating gastric biopsies from patients with portal hypertensive gastropathy (PHG) is to examine whether there is increased mucosal vasculature as suggested by endoscopy. However, the full spectrum of pathology findings in patients with portal hypertension (pHTN) is largely unknown. We systematically characterized the endoscopic and pathologic features in gastric biopsies from pHTN patients (study group) and compared with those from patients without pHTN (control group). The study group consisted of 550 consecutive surveillance esophagogastroduodenoscopic (EGD) biopsies, whereas the control group included 281 consecutive EGD biopsies for a variety of indications. As expected, the endoscopic prevalence of PHG was 28%, among which two-thirds showed corresponding histopathologic evidence of increased vasculature. However, non-Helicobacter pylori gastritis was the most common finding in pHTN patients on histology (40%). In addition, hyperplastic polyp was also more common in pHTN patients than in controls (6% vs 3%; P = 0.0314). In contrast, pathology findings of nonspecific reactive changes (29% vs 51%; P < 0.0001), proton pump inhibitor-related changes (16% vs 30%; P < 0.0001), and malignancy (1% vs 3%; P = 0.0138) were less common in pHTN patients. Our results show a spectrum of gastric endoscopic and pathologic findings in pHTN patients. The predominant gastric pathology in pHTN patients may be associated with pHTN-induced gastric microcirculation impairment.