Histopathological features of gastric map-like redness under image-enhanced endoscopy

Abstract Background and study aims: Map-like redness (MLR) is a characteristic feature and independent risk factor of gastric cancer after Helicobacter pylori eradication. The present study investigated the endoscopic manifestations and histopathological features of MLR. Patients and methods: We enrolled 56 consecutive MLR patients between January 2023 and July 2023. Endoscopic signs and histopathological characteristics were compared among the reddish area, transition zone, and background mucosa (areas R, T, and B, respectively). Results: The histopathological analysis showed significantly greater atrophy, gastric intestinal metaplasia (GIM), and dysplasia in area R compared to other areas (P < 0.05). Incomplete GIM predominated in area R, while complete GIM predominated in areas T and B. Area R had a higher microvascular density compared to areas T and B. Intervening parts width for area T was greater than that for area B, which was greater than that for area R (P < 0.05). Crypt opening sizes in area R were greater than those in area T, which were greater than those in area B (P < 0.05). Conclusions: The histological features of MLR included moderate-to-severe atrophy and intestinal metaplasia, incomplete GIM, increased microvascular density in the red zone, and widened intervening parts in the transition zone.