Helicobacter pylori eradication therapy improves atrophic gastritis and intestinal metaplasia: a 5-year prospective study of patients with atrophic gastritis.
OBJECTIVE
: To investigate the effect of the eradication of Helicobacter pylori on histological gastritis.


METHODS
: Twenty-six patients with moderate to severe atrophy received successful eradication therapy of H.pylori. Four patients dropped out and 22 were followed up prospectively for 5 years. The grades of gastritis were estimated from gastric biopsy specimens. The grade of intestinal metaplasia was also evaluated by dye-endoscopy using methylene blue (methylthioninium chloride). The serum levels of pepsinogen, gastrin and anti-parietal cell antibody were also determined.


RESULTS
: The grades of atrophy decreased in patients with successful eradication therapy in the gastric corpus (before vs. 5 years after eradication, 2.09 +/- 0.15 vs. 0.91 +/- 0.17; P < 0.01) and in the antrum (2.14 +/- 0.17 vs. 1.36 +/- 0.17; P < 0.01). The levels of intestinal metaplasia were also decreased in the corpus (0.91 +/- 0.24 vs. 0.50 +/- 0.16; P < 0.05) and in the antrum (1.41 +/- 0.20 vs. 1.00 +/- 0.16; P < 0.05), which was also demonstrated by the methylene blue (methylthioninium chloride) staining method (33.4 +/- 8.2% vs. 23.0 +/- 6.5%; P < 0.05). The improvement of corpus atrophy correlated well with the high serum level of pepsinogen I (P = 0.005), but showed no correlation with the levels of anti-parietal cell antibody.


CONCLUSIONS
: These results suggest that gastric atrophy and intestinal metaplasia are reversible events in some patients.
Ito
M
M
Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan. maito@hiroshima-u.ac.jp
Haruma
K
K
Kamada
T
T
Mihara
M
M
Kim
S
S
Kitadai
Y
Y
Sumii
M
M
Tanaka
S
S
Yoshihara
M
M
Chayama
K
K
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005755:Gastrins / Q000097:blood; D005757:Gastritis, Atrophic / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D007422:Intestines / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D008751:Methylene Blue; D008875:Middle Aged; D010435:Pepsinogens / Q000097:blood; D011230:Precancerous Conditions / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000097:blood / Q000382:microbiology* / Q000473:pathology
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D005755:Gastrins; D010435:Pepsinogens; D008751:Methylene Blue