title: Helicobacter pylori associated with a high prevalence of duodenal ulcer disease and a low prevalence of gastric cancer in a developing nation.
abstract: This study examines the relationship between Helicobacter pylori infection and peptic ulcer disease and gastric cancer--in particular, the presence or absence of bacteria, the grading of gastritis, and the degree of inflammation in the antral and oxyntic mucosae. The grading of gastritis and the detection of H pylori were determined by histology using the Sydney system. Of the 1006 patients examined, 34.5% had duodenal ulcer disease, 3.5% gastric ulcer disease, and 2% with coexistent ulceration. Most patients (50.2%) were classified as having non-ulcer dyspepsia. Altogether 2.4% of patients had gastric cancer and two further patients had carcinoma in the gastric stump. Of the ulcer disease patients, 87.2% had histological evidence of H pylori infection. After patients who had taken antibiotics or bismuth compounds in the preceding four weeks were excluded, 98.9% of the duodenal ulcer disease, 100% of the gastric ulcer disease, and 100% of the coexistent ulcer disease patients had evidence of H pylori infection. In patients with gastric cancer who had not taken antimicrobial agents in the four weeks before endoscopy, 83.3% had evidence of H pylori infection. Thus, there was a high rate of duodenal ulcer disease and a low rate of gastric ulcer disease in southern China, an area of low gastric cancer mortality. There was a specific topographical relationship between H pylori, the histological response, and gastroduodenal disease. Our data suggest that the status of a nation as either 'developed' or 'developing' can not be used to predict the upper gastrointestinal disease profile of its population.
authors.affiliation: Affiliated First Hospital, Sun Yat-Sen University of Medical Science, People's Republic of China.
authors.forename: P J
authors.initials: PJ
authors.lastname: Hu
authors.forename: Y Y
authors.initials: YY
authors.lastname: Li
authors.forename: M H
authors.initials: MH
authors.lastname: Zhou
authors.forename: M H
authors.initials: MH
authors.lastname: Chen
authors.forename: G G
authors.initials: GG
authors.lastname: Du
authors.forename: B J
authors.initials: BJ
authors.lastname: Huang
authors.forename: H M
authors.initials: HM
authors.lastname: Mitchell
authors.forename: S L
authors.initials: SL
authors.lastname: Hazell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D004381:Duodenal Ulcer / Q000150:complications / Q000453:epidemiology / Q000382:microbiology*; D004415:Dyspepsia / Q000382:microbiology; D005260:Female; D005756:Gastritis / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000150:complications / Q000453:epidemiology / Q000382:microbiology*; D013276:Stomach Ulcer / Q000382:microbiology