Morphometrical analysis of the relationship between Helicobacter pylori infection and pathological changes of gastric mucosa using Sano's 4 point biopsy method.
We examined Helicobacter pylori (H. p.) infection and changes in biopsied gastric mucosa as observed in biopsy specimens (inflammatory changes and atrophic changes) -with reference to their pathophysiological significance. We examined 68 patients with peptic ulcers and 19 patients with atrophic gastritis as controls. We confirmed H. p. infection of the gastric mucosa in biopsies from two points by tissue culture, microscopy and urease testing. We examined gastric mucosal flakes under microscopy, scoring the inflammatory changes and atrophic changes, from biopsies at Sano's 4 points. We compared the gastric mucosal condition of the H. p. (+) group and that of the H. p. (-) group histopathologically. The mucosal condition of the success fully treated H. p. infection group and that of the failure group were also investigated in the same way, as were the conditions before and after treatment.


RESULTS
1) The gastric mucosal inflammatory changes in the H. p. (+) group were more severe than those in the H. p. (-) group at all 4 biopsy points. 2) The gastric mucosal atrophy of the H. p. (+) group was more severe than that of the H. p. (-) group at all 4 biopsy points. 3) The gastric mucosal inflammatory changes in the treatment failure group were more severe than those in the Successful treatment group at all 4 biopsy points. 4) The gastric mucosal atrophy of the treatment failure group was more severe than that of the successful, treatment group at the anterior wall and the posterior wall of the body of the stomach. 5) The gastric mucosal inflammatory changes before treatment were more severe than those after treatment at all 4 biopsy points. 6) The gastric mucosal atrophy before treatment was more severe than that after treatment at the antrum and the angle of the stomach.


CONCLUSIONS
H. p. infection seemed to cause changes in mucosal condition, severity of gastric mucosal inflammation and gastric mucosal atrophy at all 4 of Sano's points.
Center for Digestive Diseases, Nippon Medical School Second Hospital.
A
A
Toyoshima
M
M
Ito
Y
Y
Moriyama
D000328:Adult; D000368:Aged; D001284:Atrophy; D001706:Biopsy / Q000379:methods; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000382:microbiology / Q000473:pathology*