Pyloric or Pseudopyloric Metaplasia of the Corpus Mucosa in Autoimmune Gastritis

Last updated: October 1, 2023
Sponsor: National Cheng-Kung University Hospital
Overall Status: Active - Enrolling

Phase

N/A

Condition

Connective Tissue Diseases

Heartburn

Gastrointestinal Diseases And Disorders

Treatment

Assess pyloric or pseudopyloric metaplasia of corpus by H&E stains

The assessment of corpus-predominant gastritis index (CGI), Operative Link for Gastritis Assessment (OLGA), and Operative Link on Gastric Intestinal Metaplasia assessment (OLGIM)

Assess pyloric or pseudopyloric metaplasia of corpus by TFF2 immunohistochemistry stains

Clinical Study ID

NCT05238181
B-ER-110-440
  • Ages 20-90
  • All Genders

Study Summary

The study is aimed to investigate the different rates of pyloric/ pseudopyloric metaplasia or spasmolytic polypeptide-expressing metaplasia (SPEM) of corpus between autoimmune gastritis and H. pylori-infected non-ulcer dyspepsia.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patients who present with relevant symptoms or signs of upper gastrointestinaldiseases, including, but not limited to the following: impaired gastric emptying,epigastric discomfort, postprandial bloating, early satiety, epigastric pain, acidregurgitation, dyspepsia, anemia, or vitamin B12 deficiency, or iron deficiency, arecandidates to be enrolled to receive gastroscopy.

Exclusion

Exclusion Criteria:

  • The exclusion criteria are as follows including use of aspirin, non-steroidalanti-inflammatory drugs, or cyclooxygenase-2 selective inhibitors for more than 3months, or diagnosis with upper gastrointestinal cancer including esophagus, stomach,duodenum, mucosa-associated lymphoid tissue lymphoma, other gastric lymphoma, orpancreas.

Study Design

Total Participants: 300
Treatment Group(s): 3
Primary Treatment: Assess pyloric or pseudopyloric metaplasia of corpus by H&E stains
Phase:
Study Start date:
January 01, 2022
Estimated Completion Date:
December 31, 2024

Study Description

Autoimmune gastritis is not an uncommon disease among northern European ancestry, but its prevalence rates are unclear in other populations, including Taiwanese. A study showed that near 2% of persons more than 60 years old have undiagnosed pernicious anemia, one of the complications of autoimmune gastritis. Believed to be undiagnosed, patients are at risk of gastric malignancy and vitamin B12 deficiency-related complications until the end stage. Therefore, use of available diagnostic tools to diagnose patients with autoimmune gastritis has been important. However, autoimmune gastritis has a silent course and is not easy to be early recognized. Early recognition is important because in the late stage, vitamin B12 replacement treatment may correct pernicious anemia only but not neurologic disorders. Fundus and corpus atrophy with parietal cells loss presented 2 to 3 decades before anemia develops in autoimmune gastritis. It is no doubt that autoimmune gastritis could be diagnosed if vitamin B12 deficiency with megaloblastosis and anemia developed; however, it could be diagnosed earlier if the gastric pathological finding was noticed to be a diagnostic clue. Nevertheless, fundus and corpus atrophy is presented not only in autoimmune gastritis but also in H. pylori-related gastropathy. Therefore, we need a pathologic feature which could help physicians differentiate autoimmune gastritis from H. pylori-infected gastropathy. Here, we propose that pyloric or pseudopyloric metaplasia of corpus is distinct from H. pylori-infected gastropathy. We believe that this specific pathologic feature will be helpful to diagnose patients with autoimmune gastritis.

Connect with a study center

  • National Cheng Kung University Hospital

    Tainan, 704302
    Taiwan

    Site Not Available

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