Chronic atrophic antral gastritis and risk of metaplasia and dysplasia in an area with low prevalence of Helicobacter pylori.
BACKGROUND
The Northeastern region of Peninsular Malaysia is an area with exceptionally low prevalence for Helicobacter pylori infection. The risk of intestinal metaplasia and dysplasia in patients with chronic atrophic gastritis (CAG) and its association with Helicobacter pylori is unknown in this region.


METHODS
This was a cross-sectional study on gastric biopsies from 234 consecutive patients (mean age 53.5 [14.8] years) who underwent upper gastrointestinal endoscopy between January 2006 and December 2006.


RESULTS
There were 137 (59%) men and 185 (79%) Malay patients. Among 234 biopsies, CAG was found in 99 and non-atrophic gastritis in 135. Intestinal metaplasia and dysplasia were detected in 8 and 6 atrophic gastritis biopsies, respectively, and in 10 and 3 of non-atrophic gastritis biopsies, respectively. H. pylori were detected in 16 (9 Malays, 7 non- Malays) biopsies (p=0.024); intestinal metaplasia was detected in 4 biopsies (p=0.3) and dysplasia in 5 biopsies (p=0.3). Of the 218 biopsies negative for H. pylori, intestinal metaplasia was found in 14 and dysplasia in 4. The risk of intestinal metaplasia as well as dysplasia was associated with presence of H. pylori infection (p=0.029 and p<0.001 respectively).


CONCLUSIONS
Even in a setting of low prevalence of H. pylori, intestinal metaplasia and dysplasia were significantly associated with H. pylori infection. The frequency of intestinal metaplasia and dysplasia was similar different between biopsies with atrophic gastritis and non-atrophic gastritis.
Yeh
Lee Yeong
LY
Department of Medicine, University Sains Malaysia, Kelantan, Malaysia. yylee@kck.usm.my
Raj
Mahendra
M
Hassan
Syed
S
Aziz
Syed Abdul
SA
Othman
Nor Hayati
NH
Mutum
Samarendra Singh
SS
Naik
Ventakesh R
VR
D001706:Biopsy; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005757:Gastritis, Atrophic / Q000150:complications* / Q000473:pathology; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007410:Intestinal Diseases / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011706:Pyloric Antrum / Q000382:microbiology / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology
Cancer Epidemiol Biomarkers Prev. 2006 Jun;15(6):1083-94
16775164
Aliment Pharmacol Ther. 2002 Jul;16(7):1249-59
12144574
Jpn J Cancer Res. 1992 Nov;83(11):1137-42
1483928
Trans R Soc Trop Med Hyg. 2001 Jan-Feb;95(1):24-7
11280057
Scand J Gastroenterol. 1994 Mar;29(3):209-13
8209178
Cancer. 1984 Nov 1;54(9):1794-801
6478415
Am J Surg Pathol. 1995;19 Suppl 1:S37-43
7762738
N Engl J Med. 2001 Sep 13;345(11):784-9
11556297
J Gastroenterol Hepatol. 1991 May-Jun;6(3):223-34
1912432
World J Gastroenterol. 2005 Feb 14;11(6):791-6
15682469
Trans R Soc Trop Med Hyg. 2008 Dec;102(12):1226-32
18586289
Dig Dis Sci. 1999 Feb;44(2):253-6
10063908
Curr Opin Gastroenterol. 2005 Jan;21(1):32-8
15687882
Am J Gastroenterol. 2007 Jan;102(1):40-5
17100981
Am J Surg Pathol. 1996 Oct;20(10):1161-81
8827022
J Gastroenterol. 1997 Apr;32(2):273-7
9085182