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World J Gastroenterol. Jun 7, 2014; 20(21): 6412-6419
Published online Jun 7, 2014. doi: 10.3748/wjg.v20.i21.6412
Critical pathogenic steps to high risk Helicobacter pylori gastritis and gastric carcinogenesis
Inchul Lee
Inchul Lee, Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
Author contributions: Lee I contributed to the manuscript.
Supported by Doyak Research Program (2009-79398) through National Research Foundation grant funded by the Ministry of science, ICT, and Future Planning
Correspondence to: Inchul Lee, Professor, Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 43 Olympic Road 88, Songpa-Gu, Seoul 138-736, South Korea. iclee@amc.seoul.kr
Telephone: +82-2-30104551 Fax: +82-2-4727898
Received: November 20, 2013
Revised: January 6, 2014
Accepted: February 17, 2014
Published online: June 7, 2014
Processing time: 198 Days and 1.8 Hours
Core Tip

Core tip: Two critical pathogenic steps of high risk Helicobacter pylori (H. pylori) gastritis and gastric carcionogenesis are reviewed. Neutrophilic proliferative zone foveolitis is a critical pathogenic step in H. pylori gastritis inducing intensive epithelial damage. It is suggested to provide a new therapeutic goal replacing traditional bactericidal antibiotics approach. Atypical Malgun cell change is a novel premalignant condition in high risk gastropathy, which may progress and undergo malignant transformation directly. A new diagnosis system of gastritis is proposed based on the critical pathologic steps classifying low and high risk gastritis for separate treatment modality.