The pathological changes of chronic atrophic gastritis are complex, but atrophy of the intrinsic glands of the gastric mucosa is the prominent lesion. The main manifestation is the reduction in the number and function of intrinsic glands of gastric mucosa, accompanied by inflammatory cell infiltration, epithelial hyperplasia and chemosis. Glandular atrophy is the basic lesion of atrophic majesty and the main basis of pathological diagnosis. Atrophy mostly occurs with the glands below the neck of the gland, the glands become shorter, the number is reduced, and in severe cases the glands can disappear completely and the mucosa becomes thin. There can be a large infiltration of lymphocytes and plasma cells in the atrophic area, often spreading to the whole mucosa. Lymphatic follicles may be formed. Gastric active atrophic gastritis is diagnosed if there is neutrophil infiltration in the superficial layer of the mucosa, when the mucosal epithelium often undergoes necrosis, or forms erosions. I. Intestinal epithelial metaplasia or pseudopyloric glandular metaplasia Intestinal epithelial metaplasia or pseudopyloric glandular metaplasia is a common pathological change in atrophic gastritis. The degree of hyperplasia is generally positively correlated with the degree of atrophy of the intrinsic glands, i.e. the more atrophy of the intrinsic glands, the more hyperplastic glands there are. Intestinal epithelial metaplasia can be divided into two types One is complete metaplasia, also known as type I metaplasia and small intestine metaplasia. The epithelium of complete metaplasia is similar to the small intestine epithelium and contains absorptive cells, cup cells and Pan cells. Another type of gastric incomplete chemosis, also known as type II chemosis, incomplete chemosis is subdivided into gastric and colonic chemosis. The columnar cells of gastric incomplete chemosis resemble the epithelial cells of the glandular fossa of the stomach and can secrete neutral mucus, while the columnar cells of colonic incomplete chemosis secrete acidic mucus. It is generally believed that colonic type incomplete hyperplasia is closely related to gastric cancer. This is because atypical hyperplasia starts from incomplete chemosis. Pseudopyloric gland hyperplasia refers to the appearance of glands resembling normal pyloric glands in the gastric body or fundic mucosa, consisting mainly of columnar mucus cells, and endocrine cells are generally not seen. While the true pyloric gland has more gastrin cells, pseudopyloric glandular hyperplasia may be related to the loss of gastric mucosa. Second, it is worth paying attention to atrophic gastritis carditis, whose incidence is second only to gastric sinusitis, which is closely related to the occurrence of gastric cardia cancer. It can be considered as a precancerous state of pancreatic cancer, especially more closely related to the occurrence of highly differentiated intestinal type gastric cancer. Due to the peculiarities of pancreatic cancer, X-ray and gastroscopy, it is often easy to miss the diagnosis, and the histology is often highly differentiated adenocarcinoma, which is not easily distinguished from benign lesions. Therefore, we should pay more attention to atrophic gastritis pancreatitis and review it regularly. During the examination, it is important to check carefully and conscientiously in order to improve the correct rate of diagnosis and avoid misdiagnosis by omission.