From the Guidelines
The stomach's histology is characterized by four main layers: mucosa, submucosa, muscularis externa, and serosa, with regional variations in gland types and cell distributions. The mucosa, which directly contacts food, has simple columnar epithelium with gastric pits leading to gastric glands. These glands contain specialized cells: parietal cells (producing hydrochloric acid), chief cells (secreting pepsinogen), mucous neck cells (producing protective mucus), enteroendocrine cells (releasing hormones), and stem cells (for epithelial renewal) 1. The submucosa contains blood vessels, lymphatics, and nerve fibers. The muscularis externa has three muscle layers (inner oblique, middle circular, and outer longitudinal) that enable stomach motility. The outermost serosa is a thin layer of connective tissue covered by mesothelium.
Some key points to consider about the stomach's histology include:
- Regional variations exist, with the cardia containing mucous-secreting glands, the fundus and body housing acid-secreting glands, and the pylorus featuring more G cells that produce gastrin 1.
- The histological classification of gastric cancer, such as the Lauren classification, is important for diagnosis and treatment 1.
- Atrophic gastritis (AG) is a condition where the stomach lining becomes thin and inflamed, and can lead to the loss of gastric glands and replacement with metaplastic epithelium 1.
- The diagnosis of AG should be confirmed by histopathology, and the severity and topographic distribution of atrophic lesions are well-established determinants of gastric cancer risk 1.
In terms of the histology of the stomach, it is essential to understand the different layers and cell types, as well as the regional variations and potential pathological changes, such as atrophic gastritis. This knowledge can help guide diagnosis and treatment of stomach-related disorders, and improve patient outcomes 1.
From the Research
Histology of the Stomach
The histology of the stomach is a complex topic, and research has shown that various factors can affect the stomach's histological structure.
- The use of proton pump inhibitors (PPIs) has been linked to changes in the stomach's histology, including an increased risk of gastric cancer 2, 3.
- PPIs can cause hypergastrinemia, gastric atrophy, and bacterial overgrowth in the stomach, which can lead to neoplastic progression 3.
- The relationship between PPI use and gastric cancer risk is still being studied, but current evidence suggests that long-term PPI use may be associated with an increased risk of gastric cancer 2, 3.
- Other factors, such as Helicobacter pylori infection, can also affect the stomach's histology and increase the risk of gastric cancer 4, 3.
- The use of PPIs in patients with autoimmune atrophic gastritis (AAG) has been shown to increase the risk of developing gastric neoplastic lesions 2.
Proton Pump Inhibitors and Stomach Histology
PPIs are widely used to treat acid-related disorders, but their use can have unintended consequences on the stomach's histology.
- PPIs can alter the stomach's microbiome and increase the risk of gastric cancer 5.
- The use of PPIs in cancer patients can also interact with anticancer drugs and affect treatment outcomes 6, 5.
- The mechanisms by which PPIs affect the stomach's histology are complex and involve multiple pathways, including the inhibition of gastric acid secretion and the alteration of the stomach's microbiome 4.