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Int J Clin Exp Pathol 2(3),239-248;2009

Original Article
A Morphometric Study of Antral G-Cell Density in a Sample of Adult General Population:
Comparison of Three Different Methods and Correlation with Patient Demography,
Helicobacter pylori Infection, Histomorphology and Circulating Gastrin Levels

Fredrik Petersson, Kurt Borch, Jens F Rehfeld and Lennart E. Franzén

Pathology Research Department, Ryhov Hospital, Jönköping, Department of Surgery and Department of Pathology II, University Hospital of
Linköping, Sweden and Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Denmark and Department of
Pathology, University Hospital, Örebro, Sweden.

Received 11 August 2008; Accepted 17 September 2008; Available online 2 October 2008

Abstract: Background: Helicobacter pylori infection has been linked to hypergastrinemia and either decreased or normal G-cell content in the
antral mucosa. Aims: To quantitatively determine antral G-cell content on the same biopsy specimens with three different methods, whether
these methods are intercorrelated and the relation of these methods to plasma gastrin concentrations, demography, the occurrence of H. pylori
infection and chronic gastritis. Material and methods: Gastric antral mucosal biopsy sections from 273 adults (188 with and 85 without H pylori
infection) from a general population sample were examined immunohistochemically for G-cells using cell counting, stereology (point counting)
and computerized image analysis. Gastritis was scored according to the updated Sydney system. Basal plasma gastrin concentrations were
measured by radioimmunoassay. Results: The three methods for G-cell quantification were poorly correlated and the results showed no
correlation with basal plasma gastrin concentrations. The antral G-cell density and scores for H. pylori colonization were positively related to
age. Neither the scores for chronic inflammation, nor the scores for inflammatory activity, atrophy or intestinal metaplasia were consistently
related to the antral G-cell content. Conclusions: The results of three techniques for G-cell quantification in the gastric antral mucosa were
poorly intercorrelated and none of the methods correlated with plasma gastrin concentrations. Age and scores for H pylori colonization seem to
be determinants of the G-cell density. That common morphometric techniques correlate poorly is of utmost importance to bear in mind when
quantitative morphological studies are planned, compared or interpreted. (IJCEP808003).

Key Words: Gastrin, cell counting, computerized image analysis, gastritis, inflammation, morphometry, point counting, stereology, stomach.

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Address all correspondence to: Fredrik Petersson, MD, PhD, Department of Pathology, Karolinska University Hospital, S-171 76, Stockholm,
Sweden, Telephone: +46733509002, Fax: +46851774524, E-mail: