title: Association between gastric atrophy and Helicobacter pylori infection in Japanese children: a retrospective multicenter study.
abstract: The purpose of this study was to determine whether Helicobacter pylori infection and mucosal inflammation result in gastric atrophy in Japanese children. A total of 196 patients ages 1-16 years were retrospectively studied: 131 patients were infected with H. pylori and 65 patients were uninfected. Antral (n = 196) and corpus biopsy specimens (n = 70) were investigated based on the Updated Sydney system. In both the antrum and corpus, H. pylori-infected patients showed significantly higher degrees of inflammation and activity of gastritis, compared with noninfected patients. The prevalence of grade 2 or 3 atrophy in the antrum was 10.7% in H. pylori-infected patients and 0% in the noninfected patients (P < .01) and in corpus 4.3% and 0%, respectively (P = .20). The frequency of intestinal metaplasia in the 2 study groups was 4.6% and 4.6% in the antrum and 0% and 4.2% in the corpus, respectively. Among H. pylori-infected patients, the antrum showed significantly higher degrees of H. pylori density, inflammation and activity of gastritis, and atrophy than the corpus. In the antrum, atrophy was significantly correlated with activity, whereas in the corpus, atrophy correlated with H. pylori density, inflammation, and activity. H. pylori-induced gastric inflammation can cause atrophy in Japanese children, predominantly in the antrum. It remains to be determined whether H. pylori-infected children with gastric atrophy are at increased risk for gastric cancer.
authors.affiliation: Department of Pediatrics, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. skato@ped.med.tohoku.ac.jp
authors.forename: Seiichi
authors.initials: S
authors.lastname: Kato
authors.forename: Shigemi
authors.initials: S
authors.lastname: Nakajima
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Nishino
authors.forename: Kyoko
authors.initials: K
authors.lastname: Ozawa
authors.forename: Takanori
authors.initials: T
authors.lastname: Minoura
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Konno
authors.forename: Shunichi
authors.initials: S
authors.lastname: Maisawa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Toyoda
authors.forename: Norikazu
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Ajula
authors.initials: A
authors.lastname: Vaid
authors.forename: Robert M
authors.initials: RM
authors.lastname: Genta
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005757:Gastritis, Atrophic / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors