title: Atrophic gastritis and Helicobacter pylori infection in outpatients referred for gastroscopy.
abstract: BACKGROUND
  Atrophic gastritis has been shown to be one of the long term sequelae of Helicobacter pylori infection.
  
  
  OBJECTIVE
  To determine the prevalence of atrophic gastritis in outpatients, to study the accuracy of serological methods for revealing atrophy, and to define the association of H pylori infection with atrophic gastritis in these patients.
  
  
  METHODS
  A total of 207 consecutive outpatients referred for gastroscopy were included. Biopsy specimens from the antrum and corpus were assessed histologically according to the Sydney system. Serum samples were studied for H pylori IgG and IgA antibodies by enzyme immunoassay, CagA antibodies by immunoblot, pepsinogen I by an immunoenzymometric assay, gastrin by radioimmunoassay, and parietal cell antibodies by indirect immunofluorescence.
  
  
  RESULTS
  Histological examination revealed atrophic gastritis in 52 (25%) of 207 patients. H pylori and CagA antibodies were strongly associated with atrophic antral gastritis but poorly associated with atrophic corpus gastritis. Low serum pepsinogen I was the most sensitive and specific indicator of moderate and severe atrophic corpus gastritis. All six patients with moderate atrophic corpus gastritis had H pylori infection but eight of 10 patients with severe atrophic corpus had increased parietal cell antibodies and nine had no signs of H pylori infection.
  
  
  CONCLUSIONS
  Atrophic antral gastritis was strongly associated with CagA positive H pylori infection. Severe atrophic corpus gastritis was not determined by H pylori tests but low serum pepsinogen I, high gastrin, and parietal cell antibodies may be valuable in detecting these changes.
authors.affiliation: Herttoniemi Municipal Hospital, FIN-00800 Helsinki, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Oksanen
authors.forename: P
authors.initials: P
authors.lastname: Sipponen
authors.forename: R
authors.initials: R
authors.lastname: Karttunen
authors.forename: A
authors.initials: A
authors.lastname: Miettinen
authors.forename: L
authors.initials: L
authors.lastname: Veijola
authors.forename: S
authors.initials: S
authors.lastname: Sarna
authors.forename: H
authors.initials: H
authors.lastname: Rautelin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial; D001323:Autoantibodies / Q000032:analysis; D001426:Bacterial Proteins / Q000097:blood*; D005260:Female; D005755:Gastrins / Q000097:blood; D005757:Gastritis, Atrophic / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000276:immunology; D020116:Pepsinogen A / Q000097:blood; D015995:Prevalence; D012680:Sensitivity and Specificity; D012698:Serologic Tests; D013270:Stomach / Q000473:pathology
chemical_list: D000942:Antigens, Bacterial; D001323:Autoantibodies; D001426:Bacterial Proteins; D005755:Gastrins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; C080866:cagA protein, Helicobacter pylori; D020116:Pepsinogen A