Assessment of correlation between histopathologic changes of gastric mucosa according to Whitehead’s classification and extent of liver damage according to Knodell’s scale in patients with chronic hepatopathy
Marcin Orłowski, Piotr Stalke, Zofia Michalska, Katarzyna Sikorska, Krystyna Witczak-Malinowska, Janina Ellert-Żygadłowska, Julian Stolarczyk
Med Sci Monit 2003; 9(3): 60-63
Background: Patients with chronic liver damage often suffer from functional disturbances and pathologic changes in the stomach, including ulceration, erosions and chronic gastritis. It was attempted to establish whether there is a correlation between histopathologic abnormalities of the gastric mucosa and the extent of histopathologic changes in liver bioptates, i.e. inflammatory activity and fibrosis (Knodell’s index) in patients with chronic hepatopathy. Material/Methods: The study was carried out in 4 groups of patients: group I - 10 subjects with autoimmune hepatitis, group II – 9 patients with chronic toxic liver damage, group III – 11 patients with chronic hepatitis caused by HBV, and group IV - 36 patients with chronic hepatitis caused by HCV. All the patients underwent gastroscopy with collection of gastric mucosa bioptates (from the antrum and the gastric body) as well as liver biopsy.Results: The most frequent gastroscopy finding in all the studied groups were signs of gastritis: in group I -90%, in group II -78%, in group III –64% and in group IV-99%. Gastric mucosa histopathology assessed according to Whitehead’s classification most frequently led to the diagnosis of gastritis chronica profunda (Group I-80%, Group II-78%, Group III-73% and Group IV –58%). No correlation was found between inflammatory activity in the liver assessed according to Knodell’s scale and the extent of changes in histopathology of the gastric mucosa (p=0.1). A negative correlation which, however, does not reach significance level (p=0.054), is observed between the extent of fibrosis in liver bioptates and histopathologic abnormalities in the gastric mucous membrane. Conclusions: No statistically significant correlation between the extent of gastric mucosa damage and severity of inflammatory lesions and hepatic fibrosis was found.
Keywords: Helicobacter pylori, Liver Diseases, gastritis