title: Compartment theory in Helicobacter pylori-associated gastric carcinogenesis.
abstract: BACKGROUND
  The compartment theory has not been well investigated in gastric carcinogenesis. This study was aimed at examining the compartment alterations through the Helicobacter pylori (H. pylori)-related chronic gastritis-intestinal metaplasia-carcinoma sequence, and investigating the long-term effect of bacterial eradication on the compartment changes.
  
  
  METHODS
  Gastric biopsy specimens were obtained from subjects with H. pylori-negative normal mucosa (N = 12), H. pylori-positive non-metaplastic gastritis (N = 42), H. pylori-positive intestinal metaplasia (N = 21) and intestinal-type adenocarcinoma (N = 20). The specimens were immnostained for monocloncal antibodies against the proliferating cell nuclear antigen (PCNA) for proliferating analysis. Additionally, 50 patients with H. pylori-positive gastritis were enrolled to investigate the long-term effect of bacterial eradication on the compartment changes of gastric epithelium.
  
  
  RESULTS
  The mean PCNA labeling indices (L.I.) of non-metaplastic gastritis, intestinal metaplasia and adenocarcinoma were significantly higher than that of normal mucosa (31.1, 49.2 and 40.7 vs. 21.4; p < 0.01, 0.001 and 0.001, respectively). The proliferating zone was principally located in the lower compartment of normal mucosa. In patients with intestinal metaplasia, there was a full expansion (phase 1 change) of proliferating zone to the middle compartment of gastric pits (ratio of L.I. between middle and lower compartment = 1.00). The proliferating cells were evenly distributed in adenocarcinoma (complete loss of compartmentalization). Eradiation of H. pylori led to a reversion of compartment changes of gastric epithelium in patients with chronic gastritis.
  
  
  CONCLUSIONS
  H. pylori-related gastric carcinogenesis is a multistep process involving progressive alterations of proliferating activity as well as loss of compartmentalization. Eradication of H. pylori reverses the changes in growth kinetics of gastric epithelium.
authors.affiliation: Department of Pathology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taipei, Taiwan, R.O.C.
authors.forename: Hui-Hwa
authors.initials: HH
authors.lastname: Tseng
authors.forename: Ping-I
authors.initials: PI
authors.lastname: Hsu
authors.forename: Hui-Chun
authors.initials: HC
authors.lastname: Chen
authors.forename: Kwok-Hung
authors.initials: KH
authors.lastname: Lai
authors.forename: Gin-Ho
authors.initials: GH
authors.lastname: Lo
authors.forename: Ching-Chu
authors.initials: CC
authors.lastname: Lo
authors.forename: Nan-Hua
authors.initials: NH
authors.lastname: Chou
authors.forename: King-Tong
authors.initials: KT
authors.lastname: Mok
authors.forename: I-Shu
authors.initials: IS
authors.lastname: Chen
authors.forename: Nan-Haw
authors.initials: NH
authors.lastname: Chou
authors.forename: Hsiao-Bai
authors.initials: HB
authors.lastname: Yang
authors.forename: Les
authors.initials: L
authors.lastname: Liu
authors.forename: Ping-Ning
authors.initials: PN
authors.lastname: Hsu
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000230:Adenocarcinoma / Q000382:microbiology* / Q000473:pathology; D000368:Aged; D002453:Cell Cycle / Q000502:physiology; D002455:Cell Division / Q000502:physiology; D002908:Chronic Disease; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005756:Gastritis / Q000382:microbiology* / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008679:Metaplasia / Q000382:microbiology / Q000473:pathology; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000382:microbiology* / Q000473:pathology; D013752:Tetracycline / Q000627:therapeutic use
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D064747:Lansoprazole; D008795:Metronidazole; D013752:Tetracycline; D009853:Omeprazole