Long-term sequelae of Helicobacter pylori gastritis.
Chronic Helicobacter pylori gastritis has been put forward as a risk factor for development of gastric mucosal atrophy and gastric cancer. The purpose of our study was to investigate the long-term effects of H pylori gastritis on the gastric mucosa. We prospectively studied 49 subjects negative for H pylori and 58 positive subjects for a mean follow-up of 11.5 years (range 10-13 years). Serum samples were obtained at the initial and follow-up visits for determination of H pylori IgG antibodies. Gastroscopies with biopsy sampling were done in all patients at both visits. Biopsy specimens were used for assessment of H pylori infection and histology. Development of atrophic gastritis and intestinal metaplasia occurred in 2 (4%) uninfected and 16 (28%) infected subjects. Regression of atrophy was noted in 4 (7%) infected subjects. Development of atrophic gastritis and intestinal metaplasia was significantly associated with H pylori infection (p = 0.0014; odds ratio 9.0, 95% CI 1.9-41.3). The proportion of atrophic gastritis in the study population showed an annual increase of 1.15% (0.5-1.8%). We conclude that H pylori infection is a significant risk factor for development of atrophic gastritis and intestinal metaplasia. Our findings support strongly the causative role of this infection in gastric carcinogenesis.
Kuipers
E J
EJ
Department of Gastroenterology, Free University Hospital, Amsterdam, Netherlands.
Uyterlinde
A M
AM
Peña
A S
AS
Roosendaal
R
R
Pals
G
G
Nelis
G F
GF
Festen
H P
HP
Meuwissen
S G
SG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology*; D005756:Gastritis / Q000150:complications / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D005757:Gastritis, Atrophic / Q000209:etiology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications / Q000276:immunology / Q000473:pathology; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007422:Intestines / Q000473:pathology; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D016017:Odds Ratio; D010437:Peptic Ulcer / Q000209:etiology / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000209:etiology
D007074:Immunoglobulin G