Сliniсoxmorfogenetical variants of gastric mucosal atrophy

Aim: to study the features of morphogenesis of atrophic process (AP) in a gastric mucosa. The clinical and pathomorphological research (light microscopy of gastrobiopsies, immunohistochemistry) has been performed to 117 patients with gastric mucosa (GM) atrophy non-associated (group 1) and associated with Helicobacter (H.) pylori-infection (group 2), features of an expression of transforming growth factor beta (TGF-?) and its receptors (TGF-?R1) in glandular and stromal compartments of GM have been studied. According to the results of comparative clinical and morphological analysis, two variants of morphogenesis of AP in GM were defined. The first variant develops in the absence of the H. pylori infection and associates with the combined influence of several endogenous risk factors of chronic gastritis and the primordial predominance of dysregenerative changes in corpus of the stomach with a pronounced tendency to atrophy of the glands. Clinically it is distinguished by a higher rate of systematic atrophic injury of gastro-intestinal tract mucosa with predominance of distending pains. The second variant is associated with a combined influence of endo- and exogenouse factors, in particular, with the presence of H. pylori-infection, pathogenetic mechanisms of "chemical" gastritis (duodeno-gastral reflux, long time defects in diet), predominance of dysregenerative and sclerotic changes in antrum. During the research of epithelio-stromal interactions according to the state of TGF-?-TGF-?R1 system we determined both common and distinct manifestations of dysbalance reflecting the peculiarities of morphogenesis of every variant. Polyaetiology of AP on the whole and the presence of its various morphological variants in GM demands both: individual diagnostic algorithm and pathogenetically based therapy in every concrete case. Determination of balance in TGF-?- TGF-?R1 system can become the important marker of violations of epithelio-stromal interactions at formation of groups of cancer development risk among patients with GM atrophy.