{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T18:10:37Z","timestamp":1789582237288,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Metaplastic alterations of oxyntic mucosa in autoimmune gastritis (AIG) remain under investigation. This study aimed to characterize pyloric gland\u2010like and intestinal metaplasia (IM) in AIG and assess their origin and prognostic significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis of 147\n                      <jats:italic>H. pylori<\/jats:italic>\n                      \u2010negative AIG gastric biopsies was conducted. Twenty cases underwent immunohistochemical staining for MUC5AC, MUC6 and TFF2, and double immunostaining for MUC6\u2010CDX2, MUC5AC\u2010CDX2 and TFF2\u2010CDX2.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Corpus mucosa showed pyloric gland\u2010like metaplasia in 98.6% (145\/147) and IM in 81.6% (120\/147) of cases; IM was complete in 99.2% (119\/120). Epithelial dysplasia was absent; one signet\u2010ring cell carcinoma was identified. Most cases were OLGA stage II (92.5%) and OLGIM stage I (58.5%). Metaplastic pyloric\u2010like glands expressed MUC6, the mucin of normal antral glands, but also MUC5AC, the mucin of gastric pits and surface epithelium, a combination congruent with a distinct metaplastic subtype. All cases exhibited biphenotypic gastric mucous cells co\u2010expressing MUC5AC\u2010CDX2 (median 4.8% of MUC5AC\u2010positive cells) and MUC6\u2010CDX2 (median 3.1% of MUC6\u2010positive cells) in glands and surface\/foveolar epithelium. Glands with a mixed cellular population showing mucinous, biphenotypic, intestinal and intermediate \u2018transition\u2019 features provided further evidence of intestinal trans\u2010differentiation. TFF2 was present in 25% (5 cases), in few glandular cells without CDX2 co\u2010expression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Oxyntic mucosa metaplasia in AIG constitutes a complex phenomenon of successive phases of cellular plasticity characterized by the appearance of a distinct pyloric\u2010like metaplastic subtype followed by intestinal trans\u2010differentiation. The autoimmune metaplastic background appears non\u2010carcinogenic regarding intestinal\u2010type adenocarcinoma development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/his.70061","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T11:04:03Z","timestamp":1765796643000},"page":"1051-1058","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["New insights in metaplasia in autoimmune gastritis"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9511-6393","authenticated-orcid":false,"given":"Tatiana S","family":"Driva","sequence":"first","affiliation":[{"name":"1st Department of Pathology, General Hospital of Athens \u201cLaiko\u201d Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3639-6807","authenticated-orcid":false,"given":"Stratigoula","family":"Sakellariou","sequence":"additional","affiliation":[{"name":"1st Department of Pathology, General Hospital of Athens \u201cLaiko\u201d Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9313-3528","authenticated-orcid":false,"given":"Irene","family":"Theochari","sequence":"additional","affiliation":[{"name":"1st Department of Pathology, General Hospital of Athens \u201cLaiko\u201d Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9851-1190","authenticated-orcid":false,"given":"Georgios","family":"Gadetsakis","sequence":"additional","affiliation":[{"name":"1st Department of Pathology, General Hospital of Athens \u201cLaiko\u201d Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0438-8562","authenticated-orcid":false,"given":"Andreas","family":"Koutsoumpas","sequence":"additional","affiliation":[{"name":"Academic Department of Gastroenterology General Hospital of Athens \u201cLaiko\u201d, Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6196-5733","authenticated-orcid":false,"given":"Ioanna","family":"Delladetsima","sequence":"additional","affiliation":[{"name":"1st Department of Pathology, General Hospital of Athens \u201cLaiko\u201d Medical School, National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16071310"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562848211038771"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2022.04.006"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEG.S109123"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-2134"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.06.078"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2023-331164"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25524"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2019.151"},{"key":"e_1_2_11_11_1","first-page":"67","article-title":"The incidence of neoplasia in patients with autoimmune metaplastic atrophic gastritis: a renewed call for surveillance","volume":"32","author":"Mahmud N","year":"2019","journal-title":"Ann. 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