Publication: Prevalence of Helicobacter pylori infection rate in heterotopic gastric mucosa in histological analysis of duodenal specimens from patients with duodenal ulcer.
Authors
Noguchi, Hirotsugu ; Kumamoto, Keiichiro ; Harada, Yoshikazu ; Sato, Naoko ; Nawata, Aya ; Tasaki, Takashi ; Kimura, Satoshi ; Shimajiri, Shohei ; Nakayama, Toshiyuki
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Publisher
Universidad de Murcia, Departamento de Biologia Celular e Histiologia
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DOI
https://doi.org/10.14670/HH-18-142
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info:eu-repo/semantics/article
Description
Abstract
Heterotopic gastric mucosa in the duodenal
bulb is a rare congenital disorder with varied clinical
presentations. The mechanism of formation of a
duodenal ulcer is failure of balance of the attack factor
and the defense factor, which is the same as the
mechanism of formation of a gastric ulcer. However, the
true etiology of the duodenal ulcer remains unknown.
Gastric mucosa can secrete gastric juice which injures
itself, but the duodenal mucosa does not contain cells
secreting a digestive enzyme. We assume that duodenal
ulcers are caused by the presence of heterotopic gastric
mucosa that can secrete gastric acid. This study was
designed to assess the prevalence and associations of
heterotopic gastric mucosa in duodenal ulcers.
The present study included 137 patients who
underwent biopsy or resection of duodenal ulcer. We
detected gastric foveolar metaplasia due to inflammation
from a heterotopic gastric mucosa using immunohisto-
chemical staining. Heterotopic gastric mucosa consists
of foveolar epithelium (MUC5AC-positive) and fundic
gland (H +K+ ATPase-positive parietal cells, pepsinogen
I-positive chief cells and MUC6-positive mucous neck
cells), whereas gastric metaplasia is composed of
foveolar epithelium without fundic glands. These
specimens were stained with toluidine blue for detection
of Helicobacter pylori infection.
Among the 137 patients with duodenal ulcer, 76
cases (55%) had heterotopic gastric mucosa in the
obtained specimens, and Helicobacter pylori was found
in 45 cases (59%,45/76) among those with heterotopic
gastric mucosa. Our results suggest that heterotopic
gastric mucosa was strongly associated with concurrent
duodenal ulcer.
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Citation
Histology and Histopathology Vol. 35, nº 2 (2020)
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