GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
ENDOSCOPIC STUDY OF PATHOPHYSIOLOGICAL CHANGES IN VARIOUS GASTRODUODENAL DISORDERS WITH SPECIAL REFERENCE TO THE STATUS OF GASTRIC MUCOSA AND GASTRIC ACID-PEPSIN SECRETION
Akihiro SHIMIZU, Kazumasa MIKI, Hiroshi OKA
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1988 Volume 30 Issue 2 Pages 291-302

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Abstract
The endoscopic examination with biopsy and both levels of pepsinogen I, II (PG I, PG II) in the serum (S) and mucosa (M) were performed in 187 subjects. Ninety-five cases of them received the endoscopic Congo red test and 84 cases received gastric analyses on another day. The results were obtained as follows :1) Compared with the endoscopically normal cases (NOR), the gastric ulcer cases (UV) had significantly lower values of SPGI/ SPGII (P <0.05) and a low tendency of SPGI, CPGI, CPGII, APGII, CPGI/CPGII and values of gastric acid-pepsin outputs. The duodenal ulcer cases (UD) had significantly higher values of SPGI, CPGI and the maximum acid output (MAO) (P<0.05-0.01) and a high tendency of SPG II, SPGI/SPGII, basic acid output (BAO), basic pepsin output (BPO) and stimulated pepsin output (SPO), while the gastric cancer cases (CA) had significantly lower values of SPGI, SPGI/SPGII and CPG I (P <0.01-0.001) and a low tendency of CPG II, CPGI/CPGII, CPGII/APGII and values of gastric acid-pepsin outputs. 2) In the study of the histological findings in the mucosa of the corpus, there were 14.7% of atrophic gastritis (AG) and 5.9% of metaplasia (M) found in NOR group, while there were 50.0% of AG and 17.5% of M found in UV group, 11.5% of AG and 3.8% of M found in UD group, 83.3% of AG and 27.8% of M found in CA group. Compared with the NOR group, UV and CA groups had a significantly higher rate of AG (P <0.05) and a high tendency of M. 3) In the study of types of glandular border determined by the endoscopic Congo red test, there were 80.0% of closed type found in NOR group, while 64.3%, 94.2% and 33.3% found in UV, UD and CA groups, respectively. 4) A significant correlation was found among the levels of serum pepsinogen, the levels of mucosa pepsinogen and the gastric secretion. In conclusion, different states of the gastric mucosa were observed in various gas-troduodenal disorders and close relationships were found among morphological, biochemi-cal and physiological changes of the gastric mucosa.
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© Japan Gastroenterological Endoscopy Society
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