Helicobacter pylori and telomerase activity in intestinal metaplasia of the stomach.
BACKGROUND
Helicobacter pylori (H. pylori) has been considered a definitive carcinogen in gastric cancer. Telomerase is activated in gastric cancer and some premalignant gastric lesions, including intestinal metaplasia (IM). In this study, we evaluated the relationships of both H. pylori infection and telomerase activity with endoscopic and histologic features in IM. The effects of H. pylori eradication on endoscopic, histologic and biochemical changes were evaluated.


METHODS
Endoscopic biopsies were obtained from 43 patients with IM for rapid urease, histologic and telomerase tests. The endoscopic and histologic features, H. pylori infection and telomerase were assessed. After H. pylori eradication, 15 patients were re-evaluated and compared after 4 months.


RESULTS
Thirty-four (79.1%) patients were infected with H. pylori. The incidence of H. pylori infection was borderline correlated to the severity of IM (p = 0.076). Telomerase was elevated in eight (18.6%) patients. Telomerase tends to be high in subtype III and endoscopic grade III of IM. After H. pylori eradication, endoscopic extent (p = 0.039) and histologic severity (p = 0.074) showed improvements, and telomerase decreased significantly (p = 0.0001).


CONCLUSIONS
Our data suggest that telomerase is associated with the severity and extent of IM and that H. pylori eradication improves the endoscopic and histologic features in IM, and decreases telomerase activity. H. pylori eradication can be considered one of the methods to prevent gastric cancer in patients with H. pylori-infected IM. Further long-term and large-scaled study will be needed.
Chung
Il Kwun
IK
Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Chonan Hospital, Soonchunhyang University Medical College, Chonan, Korea. euschung@sparc.schch.co.kr
Hwang
Kyu Yoon
KY
Kim
In Ho
IH
Kim
Hong Soo
HS
Park
Sang Heum
SH
Lee
Moon Ho
MH
Kim
Chang Jin
CJ
Kim
Sun Joo
SJ
D005260:Female; D016481:Helicobacter Infections / Q000201:enzymology*; D016480:Helicobacter pylori; D006801:Humans; D007413:Intestinal Mucosa / Q000201:enzymology / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000201:enzymology / Q000382:microbiology; D008875:Middle Aged; D011230:Precancerous Conditions / Q000201:enzymology / Q000382:microbiology; D013274:Stomach Neoplasms / Q000201:enzymology* / Q000382:microbiology; D019098:Telomerase / Q000378:metabolism*
D019098:Telomerase