The Role of Morphometry in Diagnostic of Chronic Gastritis

Chronic gastritis is one of the most frequent gastric diseases. The morphometry in diagnostic of chronic gastritis can as appear to be a potentially significant tool. The evaluation of the histoarchitectural structure of the gastric mucosa and quantification of the various neuroendocrine cells develop the new objective methods to describe changes caused by chronic gastritis. The development of specimen digitalization and computer image processing systems offer possibilities of automatization of this process on every high level. Based on the endoscopic evaluation and mucosa biopsy analysis, variable numbers and various subtypes of the neuroendocrine (NE) cells have been described in association with different types of chronic gastritis. The neuroendocrine cell population, such as enterochromaffin-like cells (ECL), G cells, and D cells may occur as hyperplastic lesions, hypergastrinemia, hyperplasia, dysplasia, possibly type-1 gastric tumour or proliferation as an indirect effect of modern drugs, suppressing acid secretion (the postpharmacotherapeutic hypoor achlorhydric status). The wide range of methods used for evaluation of NE cells density in the histological slides from counting the number of cells per one microscopic field to shape diversity of gastric glands are frequently discussed in the literature. However, there is still a lack of acknowledged evidence on the participation of NE cells in stomach inflammation pathology and the relation between NE cells density and type of chronic gastritis require further investigation. The morphometry analysis of the mucosa specimen supported by the computerized automatic evaluation can be frequently taken into account in order to reflect the mechanism of stomach inflammation. In that analysis, other factors such as presence of Helicobacter pylori, sex and anatomical region of biopsy should be included and discussed. In this chapter we focused on the following topics: • Investigation of the role of different types of NE cells in chronic gastritis. • Methodology of the evaluation of NE cells population in mucosa histological slides – different approaches and measures. • Statistical investigation of the observed variations in the NE cells population with respect to diagnosis (type of chronic gastritis), anatomical region, Helicobacter pylori, sex, hyperplasia and other factors. • Selected aspects of the computerization of automatic quantitative evaluation and space distribution of the NE cells, evaluation of the shape of mucosa glands and