A gyomornyálkahártya károsító hatásokra bekövetkező eltérései különböző morfológiai és klinikai tüneteket okoznak. Az eltérések változatos szempontok szerint osztályozhatók. Az áttekintést nehezíti, hogy azonos kóros hatások különböző, eltérő noxák pedig hasonló jellegű elváltozásokat okozhatnak. A gyomornyálkahártyában megjelenő kóros folyamatok pontosabb megismerése az ismeretek újragondolását igényli. A szerzők a gastritisek és a gastropathiák meghatározására, osztályozására és jellemzőinek bemutatására tesznek kísérletet. A gastritis szövettani meghatározás, amely a nyálkahártya gyulladását jelöli. Az akut gastritist fertőzések okozzák. Az idült gastritis két legfontosabb formája az autoimmun eredetű metaplasztikus atrophiás gastritis és a Helicobacter pylori okozta krónikus gyulladás. A gastropathia a nyálkahártya különböző szerkezeti eltéréseinek megnevezése, amelyekben a gyulladásos jelek igen mérsékelt, másodlagos eltérésként jelennek meg. A gastropathiák az eltérést kiváltó kóros hatás, a megjelenés jellege és a kialakulás módja alapján 4 csoportba oszthatók. Elkülönítésük a különböző kezelési mód és az eltérő kórjóslat miatt fontos patológiai és klinikai feladat Orv. Hetil., 2014, 155(2), 43–61.
Lee, E. L. F. M.: Gastritis and gastropathies. In: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 9th Ed. Saunders, 2010.
Lee E. L. F. M. , '', in Sleisenger and Fordtran’s Gastrointestinal and Liver Disease , (2010 ) -.
Lash, R. H., Genta, R. M.: Gastritis. In: Textbook of Clinical Gastroenterology and Hepatology. 2nd Ed. Wiley-Blackwell, 2012.
Genta R. M. , '', in Textbook of Clinical Gastroenterology and Hepatology , (2012 ) -.
Valle, D.: Peptic ulcer disease and related disorders. In: Harrison’s Gastroenterology and Hepatology. McGraw-Hill, USA, 2010.
Valle D. , '', in Harrison’s Gastroenterology and Hepatology , (2010 ) -.
Stolte, M., Meining, A.: The updated Sydney system: classification and grading of gastritis as the basis of diagnosis and treatment. Can. J. Gastroenterol., 2001, 15, 591–598.
Meining A. , 'The updated Sydney system: classification and grading of gastritis as the basis of diagnosis and treatment ' (2001 ) 15 Can. J. Gastroenterol. : 591 -598 .
Rugge, M., Correa, P., Di Mario, F., et al.: OLGA staging for gastritis: a tutorial. Dig. Liver Dis., 2008, 40, 650–658.
Mario F. , 'OLGA staging for gastritis: a tutorial ' (2008 ) 40 Dig. Liver Dis. : 650 -658 .
Fassan, M., Pizzi, M., Farinati, F., et al.: Lesions indefinite for intraepithelial neoplasia and OLGA staging for gastric atrophy. Am. J. Clin. Pathol., 2012, 137, 727–732.
Farinati F. , 'Lesions indefinite for intraepithelial neoplasia and OLGA staging for gastric atrophy ' (2012 ) 137 Am. J. Clin. Pathol. : 727 -732 .
Lash, R. H., Robert, G. Y. L., Odze, R. D., et al.: Genta inflammatory disorders of the stomach. In: Odze, R. G. (ed.): Surgical pathology of the GI tract, liver, biliary tract and pancreas. Second ed. Saunders Elsevier, 2009.
Odze R. D. , '', in Surgical pathology of the GI tract, liver, biliary tract and pancreas , (2009 ) -.
Solcia, E., Fiocca, R., Villani, L., et al.: Hyperplastic, dysplastic, and neoplastic enterochromaffin-like-cell proliferations of the gastric mucosa. Classification and histogenesis. Am. J. Surg. Pathol., 1995, 19 (Suppl. 1), S1–S7.
Villani L. , 'Hyperplastic, dysplastic, and neoplastic enterochromaffin-like-cell proliferations of the gastric mucosa. Classification and histogenesis ' (1995 ) 19 Am. J. Surg. Pathol. : S1 -S7 .
McDonald, G.: Infections of the oesophagus and stomach. In: Textbook of Clinical Gastroenterology and Hepatology. 2nd Ed. Wiley-Blackwell, 2012.
McDonald G. , '', in Textbook of Clinical Gastroenterology and Hepatology , (2012 ) -.
Laass, M. W., Pargac, N., Fischer, R., et al.: Emphysematous gastritis caused by Sarcina ventriculi. Gastrointest. Endosc., 2010, 72, 1101–1103.
Fischer R. , 'Emphysematous gastritis caused by Sarcina ventriculi ' (2010 ) 72 Gastrointest. Endosc. : 1101 -1103 .
Broutet, N., Moran, A., Hynes, S., et al.: Lewis antigen expression and other pathogenic factors in the presence of atrophic chronic gastritis in a European population. J. Infect. Dis., 2002, 185, 503–512.
Hynes S. , 'Lewis antigen expression and other pathogenic factors in the presence of atrophic chronic gastritis in a European population ' (2002 ) 185 J. Infect. Dis. : 503 -512 .
De Block, C. E., De Leeuw, I. H., Van Gaal, L. F.: Autoimmune gastritis in type 1 diabetes: a clinically oriented review. J. Clin. Endocrinol. Metab., 2008, 93, 363–371.
Gaal L. F. , 'Autoimmune gastritis in type 1 diabetes: a clinically oriented review ' (2008 ) 93 J. Clin. Endocrinol. Metab. : 363 -371 .
D’Elios, M. M., Amedei, A., Azzurri, A., et al.: Molecular specificity and functional properties of autoreactive T-cell response in human gastric autoimmunity. Int. Rev. Immunol., 2005, 24, 111–122.
Azzurri A. , 'Molecular specificity and functional properties of autoreactive T-cell response in human gastric autoimmunity ' (2005 ) 24 Int. Rev. Immunol. : 111 -122 .
D’Elios, M. M., Bergman, M. P., Azzurri, A., et al.: H+, K+-ATPase (proton pump) is the target autoantigen of Th1-type cytotoxic T cells in autoimmune gastritis. Gastroenterology, 2001, 120, 377–386.
Azzurri A. , 'H+, K+-ATPase (proton pump) is the target autoantigen of Th1-type cytotoxic T cells in autoimmune gastritis ' (2001 ) 120 Gastroenterology : 377 -386 .
Marshall, A. C., Alderuccio, F., Murphy, K., et al.: Mechanisms of gastric mucosal cell loss in autoimmune gastritis. Int. Rev. Immunol., 2005, 24, 123–134.
Murphy K. , 'Mechanisms of gastric mucosal cell loss in autoimmune gastritis ' (2005 ) 24 Int. Rev. Immunol. : 123 -134 .
Rugge, M., Correa, P., Dixon, M. F., et al.: Gastric mucosal atrophy: interobserver consistency using new criteria for classification and grading. Aliment. Pharmacol. Ther., 2002, 16, 1249–1259.
Dixon M. F. , 'Gastric mucosal atrophy: interobserver consistency using new criteria for classification and grading ' (2002 ) 16 Aliment. Pharmacol. Ther. : 1249 -1259 .
Torbenson, M., Abraham, S. C., Boitnott, J., et al.: Autoimmune gastritis: distinct histological and immunohistochemical findings before complete loss of oxyntic glands. Mod. Pathol., 2002, 15, 102–109.
Boitnott J. , 'Autoimmune gastritis: distinct histological and immunohistochemical findings before complete loss of oxyntic glands ' (2002 ) 15 Mod. Pathol. : 102 -109 .
Carmack, S. W., Genta, R. M., Graham, D. Y., et al.: Management of gastric polyps: a pathology-based guide for gastroenterologists. Nat. Rev. Gastroenterol. Hepatol., 2009, 6, 331–341.
Graham D. Y. , 'Management of gastric polyps: a pathology-based guide for gastroenterologists ' (2009 ) 6 Nat. Rev. Gastroenterol. Hepatol. : 331 -341 .
Solcia, E., Rindi, G., Fiocca, R., et al.: Distinct patterns of chronic gastritis associated with carcinoid and cancer and their role in tumorigenesis. Yale J. Biol. Med., 1992, 6, 793–804.
Fiocca R. , 'Distinct patterns of chronic gastritis associated with carcinoid and cancer and their role in tumorigenesis ' (1992 ) 6 Yale J. Biol. Med. : 793 -804 .
Cunliffe, R. N.: Alpha-defensins in the gastrointestinal tract. Mol. Immunol., 2003, 40, 463–467.
Cunliffe R. N. , 'Alpha-defensins in the gastrointestinal tract ' (2003 ) 40 Mol. Immunol. : 463 -467 .
Jevremovic, D., Torbenson, M., Murray, J. A., et al.: Atrophic autoimmune pangastritis: A distinctive form of antral and fundic gastritis associated with systemic autoimmune disease. Am. J. Surg. Pathol., 2006, 30, 1412–1419.
Murray J. A. , 'Atrophic autoimmune pangastritis: A distinctive form of antral and fundic gastritis associated with systemic autoimmune disease ' (2006 ) 30 Am. J. Surg. Pathol. : 1412 -1419 .
Bergman, M. P., Vandenbroucke-Grauls, C. M., Appelmelk, B. J., et al.: The story so far: Helicobacter pylori and gastric autoimmunity. Int. Rev. Immunol., 2005, 24, 63–91.
Appelmelk B. J. , 'The story so far: Helicobacter pylori and gastric autoimmunity ' (2005 ) 24 Int. Rev. Immunol. : 63 -91 .
Eurohepygast Study Group: Risk factors for atrophic chronic gastritis in a European population: results of the Eurohepygast study. Gut, 2002, 50, 779–785.
'Risk factors for atrophic chronic gastritis in a European population: results of the Eurohepygast study ' (2002 ) 50 Gut : 779 -785 .
Jhala, D., Jhala, N., Lechago, J., et al.: Helicobacter heilmannii gastritis: association with acid peptic diseases and comparison with Helicobacter pylori gastritis. Mod. Pathol., 1999, 12, 534–538.
Lechago J. , 'Helicobacter heilmannii gastritis: association with acid peptic diseases and comparison with Helicobacter pylori gastritis ' (1999 ) 12 Mod. Pathol. : 534 -538 .
Veijola, L., Oksanen, A., Linnala, A., et al.: Persisting chronic gastritis and elevated Helicobacter pylori antibodies after successful eradication therapy. Helicobacter, 2007, 12, 605–608.
Linnala A. , 'Persisting chronic gastritis and elevated Helicobacter pylori antibodies after successful eradication therapy ' (2007 ) 12 Helicobacter : 605 -608 .
Gologan, A., Graham, D. Y., Sepulveda, A. R.: Molecular markers in Helicobacter pylori-associated gastric carcinogenesis. Clin. Lab. Med., 2005, 25, 197–222.
Sepulveda A. R. , 'Molecular markers in Helicobacter pylori-associated gastric carcinogenesis ' (2005 ) 25 Clin. Lab. Med. : 197 -222 .
Genta, R. M., Hamner, H. W.: The significance of lymphoid follicles in the interpretation of gastric biopsy specimens. Arch. Pathol. Lab. Med., 1994, 118, 740–743.
Hamner H. W. , 'The significance of lymphoid follicles in the interpretation of gastric biopsy specimens ' (1994 ) 118 Arch. Pathol. Lab. Med. : 740 -743 .
Nordenstedt, H., Graham, D. Y., Kramer, J. R., et al.: Helicobacter pylori-negative gastritis: prevalence and risk factors. Am. J. Gastroenterol., 2013, 108, 65–71.
Kramer J. R. , 'Helicobacter pylori-negative gastritis: prevalence and risk factors ' (2013 ) 108 Am. J. Gastroenterol. : 65 -71 .
Koyama, S., Nagashima, F.: Idiopathic granulomatous gastritis with multiple aphthoid ulcers. Intern. Med., 2003, 42, 691–695.
Nagashima F. , 'Idiopathic granulomatous gastritis with multiple aphthoid ulcers ' (2003 ) 42 Intern. Med. : 691 -695 .
Xin, W., Greenson, J. K.: The clinical significance of focally enhanced gastritis. Am. J. Surg. Pathol., 2004, 28, 1347–1351.
Greenson J. K. , 'The clinical significance of focally enhanced gastritis ' (2004 ) 28 Am. J. Surg. Pathol. : 1347 -1351 .
Friedman, M., Ali, M. A., Borum, M. L.: Gastric sarcoidosis: a case report and review of the literature. South. Med. J., 2007, 100, 301–303.
Borum M. L. , 'Gastric sarcoidosis: a case report and review of the literature ' (2007 ) 100 South. Med. J. : 301 -303 .
Wu, T. T., Hamilton, S. R.: Lymphocytic gastritis: association with etiology and topology. Am. J. Surg. Pathol., 1999, 23, 153–158.
Hamilton S. R. , 'Lymphocytic gastritis: association with etiology and topology ' (1999 ) 23 Am. J. Surg. Pathol. : 153 -158 .
Carmack, S. W., Lash, R. H., Gulizia, J. M., et al.: Lymphocytic disorders of the gastrointestinal tract: a review for the practicing pathologist. Adv. Anat. Pathol., 2009, 16, 290–306.
Gulizia J. M. , 'Lymphocytic disorders of the gastrointestinal tract: a review for the practicing pathologist ' (2009 ) 16 Adv. Anat. Pathol. : 290 -306 .
Madisch, A., Miehlke, S., Neuber, F., et al.: Healing of lymphocytic gastritis after Helicobacter pylori eradication therapy – a randomized, double-blind, placebo-controlled multicentre trial. Aliment. Pharmacol. Ther., 2006, 23, 473–479.
Neuber F. , 'Healing of lymphocytic gastritis after Helicobacter pylori eradication therapy – a randomized, double-blind, placebo-controlled multicentre trial ' (2006 ) 23 Aliment. Pharmacol. Ther. : 473 -479 .
Haot, J., Berger, F., Andre, C., et al.: Lymphocytic gastritis versus varioliform gastritis. A historical series revisited. J. Pathol., 1989, 158, 19–22.
Andre C. , 'Lymphocytic gastritis versus varioliform gastritis. A historical series revisited ' (1989 ) 158 J. Pathol. : 19 -22 .
Pulimood, A. B., Ramakrishna, B. S., Mathan, M. M.: Collagenous gastritis and collagenous colitis: a report with sequential histological and ultrastructural findings. Gut, 1999, 44, 881–885.
Mathan M. M. , 'Collagenous gastritis and collagenous colitis: a report with sequential histological and ultrastructural findings ' (1999 ) 44 Gut : 881 -885 .
Dray, X., Reignier, S., Vahedi, K., et al.: Collagenous gastritis. Endoscopy, 2007, 39 (Suppl. 1), E292–E293.
Vahedi K. , 'Collagenous gastritis ' (2007 ) 39 Endoscopy : E292 -E293 .
Nagy, F., Molnár, T., Tiszlavicz, L., et al.: Ulcerative colitis and eosinophilic corpus gastritis. [Colitis ulcerosa és eosinophil corpus gastritis.] Orv. Hetil., 2004, 145, 2241–2246. [Hungarian]
Tiszlavicz L. , 'Ulcerative colitis and eosinophilic corpus gastritis. [Colitis ulcerosa és eosinophil corpus gastritis.] ' (2004 ) 145 Orv. Hetil. : 2241 -2246 .
Bori, R., Cserni, G.: Eosinophilic gastritis simulating gastric carcinoma. [Eosinophil gastritis gyomorrákot utánzó formája.] Orv. Hetil., 2003, 144, 529–531. [Hungarian]
Cserni G. , 'Eosinophilic gastritis simulating gastric carcinoma. [Eosinophil gastritis gyomorrákot utánzó formája.] ' (2003 ) 144 Orv. Hetil. : 529 -531 .
Kokkonen, J., Ruuska, T., Karttunen, T. J., et al.: Mucosal pathology of the foregut associated with food allergy and recurrent abdominal pains in children. Acta Paediatr., 2001, 90, 16–21.
Karttunen T. J. , 'Mucosal pathology of the foregut associated with food allergy and recurrent abdominal pains in children ' (2001 ) 90 Acta Paediatr. : 16 -21 .
Tuncer, K., Alkanat, M., Musoğlu, A., et al.: Gastritis cystica polyposa found in an unoperated stomach: an unusual case treated by endoscopic polypectomy. Endoscopy, 2003, 35, 882.
Musoğlu A. , 'Gastritis cystica polyposa found in an unoperated stomach: an unusual case treated by endoscopic polypectomy ' (2003 ) 35 Endoscopy : 882 -.
Genta, R. M.: Differential diagnosis of reactive gastropathy. Semin. Diagn. Pathol., 2005, 22, 273–283.
Genta R. M. , 'Differential diagnosis of reactive gastropathy ' (2005 ) 22 Semin. Diagn. Pathol. : 273 -283 .
Fukuhara, K., Osugi, H., Takada, N., et al.: Quantitative determinations of duodenogastric reflux, prevalence of Helicobacter pylori infection, and concentrations of interleukin-8. World J. Surg., 2003, 27, 567–570.
Takada N. , 'Quantitative determinations of duodenogastric reflux, prevalence of Helicobacter pylori infection, and concentrations of interleukin-8 ' (2003 ) 27 World J. Surg. : 567 -570 .
Dixon, M. F., Mapstone, N. P., Neville, P. M., et al.: Bile reflux gastritis and intestinal metaplasia at the cardia. Gut, 2002, 51, 351–355.
Neville P. M. , 'Bile reflux gastritis and intestinal metaplasia at the cardia ' (2002 ) 51 Gut : 351 -355 .
Uppal, R., Lateef, S. K., Korsten, M. A., et al.: Chronic alcoholic gastritis. Roles of alcohol and Helicobacter pylori. Arch. Intern. Med., 1991, 151, 760–764.
Korsten M. A. , 'Chronic alcoholic gastritis. Roles of alcohol and Helicobacter pylori ' (1991 ) 151 Arch. Intern. Med. : 760 -764 .
Tarnawski, A., Pai, R., Deng, X., et al.: Aging gastropathy – novel mechanisms: hypoxia, up-regulation of multifunctional phosphatase PTEN, and proapoptotic factors. Gastroenterology, 2007, 133, 1938–1947.
Deng X. , 'Aging gastropathy – novel mechanisms: hypoxia, up-regulation of multifunctional phosphatase PTEN, and proapoptotic factors ' (2007 ) 133 Gastroenterology : 1938 -1947 .
Burak, K. W., Lee, S. S., Beck, P. L.: Portal hypertensive gastropathy and gastric antral vascular ectasia (GAVE) syndrome. Gut, 2001, 49, 866–872.
Beck P. L. , 'Portal hypertensive gastropathy and gastric antral vascular ectasia (GAVE) syndrome ' (2001 ) 49 Gut : 866 -872 .
Manolios, N., Eliades, C., Duncombe, V., et al.: Scleroderma and watermelon stomach. J. Rheumatol., 1996, 23, 776–778.
Duncombe V. , 'Scleroderma and watermelon stomach ' (1996 ) 23 J. Rheumatol. : 776 -778 .
Novitsky, Y. W., Kercher, K. W., Czerniach, D. R., et al.: Watermelon stomach: pathophysiology, diagnosis, and management. J. Gastrointest. Surg., 2003, 7, 652–661.
Czerniach D. R. , 'Watermelon stomach: pathophysiology, diagnosis, and management ' (2003 ) 7 J. Gastrointest. Surg. : 652 -661 .
Ohta, M., Yamaguchi, S., Gotoh, N., et al.: Pathogenesis of portal hypertensive gastropathy: a clinical and experimental review. Surgery, 2002, 131, S165–S170.
Gotoh N. , 'Pathogenesis of portal hypertensive gastropathy: a clinical and experimental review ' (2002 ) 131 Surgery : S165 -S170 .
Westerhoff, M., Tretiakova, M., Hovan, L., et al.: CD61, CD31, and CD34 improve diagnostic accuracy in gastric antral vascular ectasia and portal hypertensive gastropathy: An immunohistochemical and digital morphometric study. Am. J. Surg. Pathol., 2010, 34, 494–501.
Hovan L. , 'CD61, CD31, and CD34 improve diagnostic accuracy in gastric antral vascular ectasia and portal hypertensive gastropathy: An immunohistochemical and digital morphometric study ' (2010 ) 34 Am. J. Surg. Pathol. : 494 -501 .
Nomura, S., Settle, S. H., Leys, C. M., et al.: Evidence for repatterning of the gastric fundic epithelium associated with Ménétrier’s disease and TGFalpha overexpression. Gastroenterology, 2005, 128, 1292–1305.
Leys C. M. , 'Evidence for repatterning of the gastric fundic epithelium associated with Ménétrier’s disease and TGFalpha overexpression ' (2005 ) 128 Gastroenterology : 1292 -1305 .
Settle, S. H., Washington, K., Lind, C., et al.: Chronic treatment of Ménétrier’s disease with Erbitux: clinical efficacy and insight into pathophysiology. Clin. Gastroenterol. Hepatol., 2005, 3, 654–659.
Lind C. , 'Chronic treatment of Ménétrier’s disease with Erbitux: clinical efficacy and insight into pathophysiology ' (2005 ) 3 Clin. Gastroenterol. Hepatol. : 654 -659 .
Metz, D. C.: Diagnosis of the Zollinger–Ellison syndrome. Clin. Gastroenterol. Hepatol., 2012, 10, 126–130.
Metz D. C. , 'Diagnosis of the Zollinger–Ellison syndrome ' (2012 ) 10 Clin. Gastroenterol. Hepatol. : 126 -130 .
Ito, T., Igarashi, H., Uehara, H., et al.: Pharmacotherapy of Zollinger–Ellison syndrome. Expert Opin. Pharmacother., 2013, 14, 307–321.
Uehara H. , 'Pharmacotherapy of Zollinger–Ellison syndrome ' (2013 ) 14 Expert Opin. Pharmacother. : 307 -321 .