Sustained increase in gastric antral epithelial cell proliferation despite cure of Helicobacter pylori infection.
OBJECTIVE
Studies of the effect of Helicobacter pylori treatment on gastric mucosa proliferation have yielded inconsistent results. We compared gastric mucosa cell proliferation posttherapy and in uninfected controls.


METHODS
Biopsies were obtained from patients with H. pylori infection before treatment and at intervals for up to 33 months. Epithelial cell proliferation was determined using Ki-67 immunostaining. The labeling index (LI) is the proportion of positively labeled cells with respect to the total number of cells. The proliferative index was calculated by multiplying the labeling index (LI) and the proliferation zone PZ (PZ = length of the area between the uppermost and lowest labeled cells).


RESULTS
The study included 27 patients with H. pylori gastritis and 35 controls. Epithelial cell proliferation (LI) was greater with H. pylori infection than without in both the antrum and corpus (65+/-5 vs 91+/-8 in the antrum and 44+/-4 vs 72+/-8 in the corpus, for uninfected controls vs H. pylori gastritis, respectively) (p = 0.0001). In the antrum there was no significant decrease in epithelial cell proliferation after cure of the H. pylori infection despite follow-up for >2 yr (labeling index = 83+/-10). In contrast, epithelial cell proliferation decreased in the corpus and became similar to that in controls after 7-13 months.


CONCLUSIONS
Patients with H. pylori infection have sustained high epithelial cell proliferation in the antrum compared to that in uninfected subjects. A continued increase in proliferation in the antrum after cure of H. pylori infection suggests continuing damage.
El-Zimaity
H M
HM
Department of Pathology, Veterans Affairs Medical Center, Baylor College of Medicine, Houston, Texas 77030, USA.
Graham
D Y
DY
Genta
R M
RM
Lechago
J
J
D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001706:Biopsy; D002455:Cell Division / Q000187:drug effects / Q000502:physiology*; D004848:Epithelium / Q000187:drug effects / Q000473:pathology; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000187:drug effects / Q000473:pathology; D005756:Gastritis / Q000188:drug therapy / Q000473:pathology*; D016481:Helicobacter Infections / Q000188:drug therapy / Q000473:pathology*; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D007124:Immunoenzyme Techniques; D019394:Ki-67 Antigen / Q000032:analysis; D011706:Pyloric Antrum / Q000187:drug effects / Q000473:pathology*; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D019394:Ki-67 Antigen