Clinicopathological characteristics of pancreatic acinar cell metaplasia associated with Helicobacter pylori infection

Abstract

Background Pancreatic acinar cell metaplasia (PACM) has been rarely reported in the gastric mucosa. In the present study, we aimed to elucidate the clinical and pathological characteristics of PACM associated with Helicobacter pylori (H. pylori). Method 5930 patients who underwent five- or two-point gastric biopsy according to the updated Sydney system (USS) by upper gastrointestinal endoscopy were enrolled. The patients were categorized into current H. pylori infection (CHI), post-H. pylori eradication (PHE), and non-H. pylori infection (NHI) groups according to the H. pylori infection status, and the frequency and location of PACM were compared. Additionally, a case–control study was performed to compare the USS scores between patients with CHI and PACM and those with CHI but not PACM. Result The frequencies of PACM were 0.49% (10/2039), 0.75% (25/3332), and 0% (0/559) in the CHI, PHE, and NHI groups, respectively. PACM was found in the greater curvature of the antrum in 33 of the 35 patients with PACM. Among the patients with CHI, the inflammation scores in the greater curvature of the antrum and the greater curvature of the corpus were lower in patients with PACM than in those without PACM. Conclusion Although rarely reported in the gastric mucosa, PACM was closely related to H. pylori infection, especially in the antrum, and was associated with relatively mild inflammation.

Diagnostic Challenges during Inflammation and Cancer: Current Biomarkers and Future Perspectives in Navigating through the Minefield of Reactive versus Dysplastic and Cancerous Lesions in the Digestive System

“…In humans, SPEM is found in the fundus of Helicobacter pylori related gastritis and in the mucosa adjacent to dysplasia-carcinoma areas [32,34]. Pancreatic acinar metaplasia is found in less than 1% of patients with chronic gastritis and is often associated with Helicobacter pylori infection [35]. It is more frequent in the antrum than in the corpus and comprises clusters of pancreatic acinar cell-like cells, along with exocrine cells with basophilic cytoplasm that are positive for B-cell lymphoma/leukemia (BCL-10) and α-amylase.…”