Helicobacter pylori and precancerous gastric lesions

Abstract

Background: To determine the relationship between Helicobacter priori (H. pylori) infection and the precancerous gastric lesions: atrophic gastritis (AG) and intestinal metaplasia (IM) and dysplasia. Methods: A total of 347 dyspeptic patients, including 141 H. pylori-positive patients and 206 H. pylori-negative patients, were studied alongside age- and sex-matched controls. The patients underwent gastroscopy and endoscopic biopsy for detection of H. pylori, and histological examinations. Helicobacter priori was detected by a urease test (CLO; Delta West; Bentley, Australia), by histology (H and E stain, Giemsa) and by serology (BioSig; BioMeditech, NJ, USA). Atrophic gastritis, IM and dysplasia were detected by histological examination (Giemsa, H and E stain). Results: There is a higher rate of atrophic gastritis in H. pylori-positive than in H. pylori-negative patients (46 vs 13.5%, odds ratio (OR) = 5.4; P < 0.01). Gastritis in H. pylori-positive patients also has a higher rate of activity than in H. pylori-negative patients. The rate of IM is higher in H. pylori-positive patients than in H. pylori-negative patients (35 vs 11%; OR = 4.3; P < 0.01). Metaplasia is more often diffuse in H. pylori-positive than in H. pylori-negative patients. Dysplasia is more common in H. pylori-positive than in H. pylori-negative patients (12 and 3.8%; OR = 3.3; P < 0.01). Conclusion: This study supports the suggestion of a relationship between H. priori infection and precancerous gastric lesions. Wherever H. priori is present, the precancerous lesions are more common and more severe.