Clinicopathologic Features of the Duodenum Related to the Genesis of Duodenal Gastric Metaplasia

Jang, Tae Jung

Abstract

BACKGROUND/AIMS
It has been suggested that gastric metaplasia in the duodenum is prerequisite for duodenal ulcer. The aim of this study was to investigate the role of clinicopathologic parameters of the duodenum such as endoscopic diagnosis, pathologic findings and Helicobacter pylori (H. pylori) infection on the development of gastric metaplasia.
METHODS
Endoscopic records as well as pathologic findings of 390 patients were reviewed. The degree of gastric metaplasia in duodenum was evaluated. H. pylori infection was determined by immunohistochemical staining.
RESULTS
The degree of gastric metaplasia was higher in duodenal ulcers and hyperplastic duodenal polyps than in chronic duodenitis. The degree of gastric metaplasia was closely related to severe acute inflammation, mild chronic inflammation and H. pylori infection in duodenum. Duodenal ulcers showed higher acute inflammation and a higher incidence of H. pylori infection than hyperplastic polyps and chronic duodenitis.
CONCLUSIONS
Gastric metaplasia in duodenal ulcers may be related to duodenal inflammation and H. pylori infection, whereas in hyperplastic polyps gastric metaplasia may occur by another mechanism.