Endoscopic, histological and serologic findings of gastric hyperplastic polyps after eradication of Helicobacter pylori: comparison between responder and non-responder cases.
BACKGROUND
Evidence indicates that eradication of Helicobacter pylori leads to the disappearance of hyperplastic polyps in the stomach. However, there are some exceptions. We have compared endoscopic and serologic findings of responder and non-responder cases with hyperplastic polyps to try to identify the cause(s), other than H. pylori infection, of the formation or growth of gastric hyperplastic polyps.


METHODS
We retrospectively studied 33 patients whose hyperplastic polyps disappeared after eradication of H. pylori and 10 patients whose hyperplastic polyps did not disappear after eradication. The patients were examined both endoscopically and serologically before, 1-3 months after and 12-15 months after the eradication.


RESULTS
The responder and non-responder groups were similar with respect to age, sex, coexisting diseases, and histologic findings. The number and maximum size of polyps tended to be larger before treatment in the non-responder group than in the responder group. The serum gastrin level was higher in the non-responder group than in the responder group before, 1-3 months after and 12-15 months after the eradication (p=0.0096, p>0.2, p=0.0014). On histologic examination, similar reductions in the degree of inflammatory cell infiltration in the gastric mucosa of the antrum and body were seen in both the responder and non-responder groups. In the non-responders, the size and numbers of the polyps regressed in 5 of the 10 patients. The score of glandular atrophy in the antrum and the serum gastrin levels in the non-regressed cases was higher than those in the regressed cases at 1-3 and 12-15 months after eradication.


CONCLUSIONS
Persistent high gastrin levels were found in the non-responder cases with gastric hyperplastic polyps.
Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan.
Toshifumi
T
Ohkusa
Hiroto
H
Miwa
Mariko
M
Hojo
Jiro
J
Kumagai
Toru
T
Tanizawa
Daisuke
D
Asaoka
Takeshi
T
Terai
Ryuichi
R
Ohkura
Nobuhiro
N
Sato
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D004359:Drug Therapy, Combination; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005755:Gastrins / Q000097:blood; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D006965:Hyperplasia; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D020116:Pepsinogen A / Q000097:blood; D011127:Polyps / Q000473:pathology*; D054328:Proton Pump Inhibitors; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000473:pathology*
D000900:Anti-Bacterial Agents; D005755:Gastrins; D007074:Immunoglobulin G; D010406:Penicillins; D054328:Proton Pump Inhibitors; D020116:Pepsinogen A