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Endoscopic study of pathophysiological changes in various gastroduodenal disorders with special reference to the status of gastric mucosa and gastric acid pepsin secretion



Endoscopic study of pathophysiological changes in various gastroduodenal disorders with special reference to the status of gastric mucosa and gastric acid pepsin secretion



Gastroenterological Endoscopy 30(2): 291-302



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 SPG I/SPG II (P < 0.05) and a low tendency of SPG I, CPG I, CPG II, APG II, CPG I/CPG II and values of gastric acid-pepsin outputs. The duodenal ulcer cases (UD) had significantly higher values of SPG I, CPG I and the maximum acid output (MAO) (P < 0.05 .apprx. 0.01) and a high tendency of SPG II, SPG I/SPG II, basic acid output (BAO), basic pepsin output (BPO) and stimulated pepsin output (SPO), while the gastric cancer cases (CA) had significantly lower values of SPG I, SPG I/SPG II and CPG I (P < 0.01 .apprx. 0.001) and a low tendency of CPG II, CPG I/CPG II, CPG II/APG II 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 gastroduodenal disorders and close relationships were found among morphological, biochemical and physiological changes of the gastric mucosa.

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Accession: 005359641

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