Gastric foveolar elongation causes invisibility of regular arrangement of collecting venules in chronic active and inactive gastritis

Objectives Helicobacter pylori (H pylori) infection is the most common cause of gastritis. The disappearance of regular arrangement of collecting venules (RAC) is well known as one of the main manifestations of H pylori-affected gastritis while the reason behind it remains obscure. The aim of this study was to investigate the relationship between invisibility of RAC and the length of gastric foveolae. Methods 43 RAC-positive and 118 RAC-negative patients were enrolled. Gastric biopsy specimens were obtained from lesser and greater curvature of the corpus with RAC-positive or RAC-negative pattern. Histopathological evaluation was performed based on the updated Sydney System, and foveolar length was derived by a morphometric technique. Results The median gastric foveolar length in RAC-positive group (median [IQR], 138.54 mu m [120.50, 159.09]) was significantly shorter than that in the RAC-negative group (median [IQR], 260.96 mu m [217.40, 315.23], P < .05). The length of gastric foveolae in chronic active gastritis (RAC-negative, activity grades 1, 2, and 3) and inactive gastritis (RAC-negative, activity grade 0) was longer than that in normal group (RAC-positive, activity grade 0) (P < .05). The optimal cutoff value for gastric foveolae length of the corpus mucosa showing RAC-negative pattern was more than 181.53 mu m. The sensitivity and specificity of more than cutoff value for predicting the invisibility of RAC were 93.03% and 91.78%, respectively. Conclusions The elongation of gastric foveolae caused the invisibility of RAC in gastric corpus mucosa in chronic active and inactive gastritis on gastroendoscopy.

Automated summary

The disappearance of regular arrangement of collecting venules (RAC) in gastric corpus mucosa in chronic active and inactive gastritis is caused by the elongation of gastric foveolae. A length of gastric foveolae more than 181.53 µm was found to predict the invisibility of RAC with high sensitivity and specificity.