Infection and Drug Resistance (Jul 2022)
How Does Helicobacter pylori Infection Cause Gastric Mucosal Atrophy
Abstract
Yang-Kun Wang,1 Jun-Ling Zhou,2 Nian-Long Meng,3 Chao-Ya Zhu,4 Su-Nan Wang,5 Xiao-Dong Chen1 1Department of Pathology, Foresea Life Insurance Guangzhou General Hospital, Guangzhou, 511300, People’s Republic of China; 2Shenzhen Nanshan District People’s Hospital, Shenzhen, 518067, People’s Republic of China; 3Department of Pathology, The 989th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Luoyang, Henan, 471031, People’s Republic of China; 4Department of Pathology, Third Affiliated Hospital, Zhengzhou University, Zhengzhou, 450052, People’s Republic of China; 5Shenzhen Polytechnic, Shenzhen, 518055, People’s Republic of ChinaCorrespondence: Su-Nan Wang, Shenzhen Polytechnic, Bank of Xili Lake, Xilihu Town, Nanshan District, Shenzhen City, 518055, People’s Republic of China, Tel/Fax +86-0755-26731494, Email [email protected] Xiao-Dong Chen, Department of Pathology, Foresea Life Insurance Guangzhou General Hospital, No. 703, New Town Avenue, Zengcheng District, Guangzhou, 511300, People’s Republic of China, Tel/Fax +86-020-32169999, Email [email protected]: To investigate the occurrence and development of gastric mucosal atrophy due to Helicobacter pylori (Hp) infection and the accompanying histomorphological features.Methods: Detailed histological observations and immunohistochemical examinations were conducted via 197 endoscopic biopsies and endoscopic submucosal dissection specimens of gastric mucosal atrophic lesions with gastric Hp infection. Detailed observation was made of columnar cells in the proliferative region of the deep gastric pit and the isthmus of the gastric gland, as well as the upper part of the glandular cervix.Results: The infection of the gastric mucosa by Hp firstly led to the proliferative disorder of stem cells in the normal proliferative region of the gastric mucosa. This caused substantial propagation of cells in the proliferative region of the deep gastric pit and the isthmus of the gastric gland, as well as the upper part of the glandular cervix, as a means to replenish the damaged surface mucus cells. However, the propagation of stem cells in the proliferative region was insufficient for downward migration, and the normal physiological process of differentiation into fundic/pyloric gland cells was disrupted, resulting in glandular atrophy of the intrinsic layer of the gastric mucosa. Persistent Hp infection and disruption of stem cell proliferation in the proliferative region subsequently resulted in extensive segmental hyperplasia of the gastric mucosa and glandular atrophy of the lamina propria.Conclusion: The occurrence, development, and histomorphological features of gastric mucosal atrophy due to gastric Hp infection provide a reliable pathological basis for precise treatment by clinicians and are of great significance for controlling the development of gastric cancer.Keywords: gastric tumor, Helicobacter pylori, mucosal atrophy, histopathology, immunohistochemistry