title: Helicobacter pylori-induced enlarged-fold gastritis is associated with increased mutagenicity of gastric juice, increased oxidative DNA damage, and an increased risk of gastric carcinoma.
abstract: OBJECTIVE
  The severe inflammation, increased cell proliferation and marked acid inhibition observed in subjects with Helicobacter pylori-associated enlarged-fold gastritis suggest that enlarged-fold gastritis may be a risk factor for gastric carcinoma. The purpose of the present study was to determine whether a relationship exists between enlarged-fold gastritis and gastric carcinoma.
  
  
  METHODS
  One hundred and thirty-five H. pylori-positive patients with early gastric carcinoma and 141 age- and sex-matched H. pylori-positive controls without gastric carcinoma were involved in the study. The widths of gastric body folds were measured by double-contrast radiographs. The mutagenicity of gastric juice was assayed using the Ames test and Salmonella typhimurium TA-98 or TA-100 with S9-mix. Levels of 8-hydroxydeoxyguanosine (8-OHdG) in gastric mucosa were examined using high-performance liquid chromatographic-electrochemical detection.
  
  
  RESULTS
  An upward shift in the distribution of gastric fold widths in H. pylori-positive patients with early gastric carcinoma was found. Enlarged-fold gastritis (fold width >/=5 mm) was observed in 81% of the patients with gastric carcinoma, compared with 46% of H. pylori-positive controls. The odds ratio for gastric carcinoma increased with increasing fold width to a maximum of 35.5 in persons with fold width >/=7 mm. The prevalence of diffuse-type early gastric carcinoma in the body region increased with increasing fold width. The mutagenicity of gastric juice from the patients with enlarged-fold gastritis was significantly higher than that in H. pylori-negative controls and H. pylori-positive patients without enlarged folds. Mucosal 8-OHdG levels in the body region of patients with enlarged-fold gastritis were significantly higher than in H. pylori-negative controls and H. pylori-positive patients without enlarged-fold gastritis. Eradication of H. pylori significantly decreased the mutagenicity of gastric juice and 8-OHdG levels in the gastric mucosa from patients with enlarged-fold gastritis.
  
  
  CONCLUSIONS
  A significant association is suggested between enlarged-fold gastritis and gastric carcinoma.
authors.affiliation: Departments of Internal Medicine and Molecular Science and Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishibayashi
authors.forename: Shuji
authors.initials: S
authors.lastname: Kanayama
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kiyohara
authors.forename: Karsumi
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Yoshiji
authors.initials: Y
authors.lastname: Miyazaki
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yasunaga
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Shinomura
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Takeshita
authors.forename: Toru
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Kanehisa
authors.initials: K
authors.lastname: Morimoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsuzawa
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004249:DNA Damage / Q000502:physiology*; D005260:Female; D005750:Gastric Juice / Q000502:physiology*; D005753:Gastric Mucosa / Q000378:metabolism / Q000473:pathology; D005758:Gastritis, Hypertrophic / Q000378:metabolism / Q000382:microbiology* / Q000473:pathology*; D016481:Helicobacter Infections / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009152:Mutagenicity Tests; D018384:Oxidative Stress / Q000502:physiology*; D013274:Stomach Neoplasms / Q000378:metabolism / Q000382:microbiology* / Q000473:pathology