Editorial
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 28, 2006; 12(36): 5757-5762
Published online Sep 28, 2006. doi: 10.3748/wjg.v12.i36.5757
Gastric atrophy, diagnosing and staging
Hala MT El-Zimaity
Hala MT El-Zimaity, Departments of Medicine and Pathology, VAMC and Baylor College of Medicine, Houston, TX, United States
Author contributions: All authors contributed equally to the work.
Correspondence to: Hala MT El-Zimaity, MD, VA medical center (111-d), 2002 Holcombe blvd. (rm. 3a320), Houston, Texas 77030, United States. hzimaity@bcm.tmc.edu
Telephone: +1-713-7950232 Fax: +1-713-7901040
Received: April 3, 2006
Revised: July 5, 2006
Accepted: July 11, 2006
Published online: September 28, 2006
Abstract

H pylori is now accepted as the cause of gastritis and gastritis-associated diseases, such as duodenal ulcer, gastric ulcer, gastric carcinoma, and gastric MALT lymphoma. The natural history of H pylori gastritis includes inflammation progressing from the antrum into the adjacent corpus resulting in an atrophic front of advancing injury leading to a reduction in acid secretion and eventual loss of parietal cells and development of atrophy. Sub-typing intestinal metaplasia has no clinical value to the patient, the pathologist, or the endoscopist. The pattern, extent, and severity of atrophy, with or without intestinal metaplasia, is a far more important predictor than is intestinal metaplasia subtype. The challenge remains to identify a reliable marker that relates to pre-malignant potential.

Keywords: Gastric atrophy; Diagnosis; Staging; H pylori