Evaluation of Histopathological Correspondence of Atrophic Gastritis Observed in Endoscopy: Systematic Review

Objective: Atrophic gastritis (AG), which is defined as the loss of gastric glands, can be precancerous. The objective of this study is examination of histopathological correlation of our patients with AG, considered according to endoscopic findings and determination of the other concomitant pathological findings. Material and Methods: Biopsy was performed in the atrophic areas and/or different areas on a total of 201 patients during gastroscopic evaluation due to the pre-diagnosis of AG between 2013 and 2014 in our clinic. Their pathological evaluation was performed and the cases of these patients were examined retrospectively. Endoscopic diagnosis of AG was made based on observation of the gastric mucosa as pale compared to the normal gastric mucosa and the separation of this area from the normal gastric mucosa, which can be defined as an endoscopic atrophic border with the prominence of submucosal thin vascular structures. Diagnosis of AG was pathologically defined as loss of glands. Results: The average age of the total 201 patients, who were 133 (67%) women and 68 (33%) men, was 69 years. Endoscopic and histological AG correlation in the whole group was 63 (31%). Considering the gastric localisation of the cases with confirmed diagnosis of AG in histopathological examination; it was determined that 89% affect the proximal, 9% the distal and 2% the distal and proximal together. Intestinal metaplasia (IM) was accompanied in 68% of cases with chronic active gastritis (21%) and neuroendocrine cell hyperplasia (NEHD) (14%). Chronic active gastritis was detected in 32% and IM 17% in cases without histopathological AG. While Helicobacter pylori positivity was 6% in those with histopathologically AG, it was 24% in those without AG (p=0.003). When evaluated in terms of accompanying pathological findings, NEHD, IM and lymphoid follicle hyperplasia were found with a higher rate in patients with histopathologically AG, and found statistically significant. Conclusion: Pathological examination must be performed if AG is suspected in endoscopy. While IM and NECH were more commonly concomitantly observed in patients with AG in pathological examination, the rate of H. Pylori was lower compared to the patients who did not have AG.