title: Ten-year prospective follow-up of histological changes at five points on the gastric mucosa as recommended by the updated Sydney system after Helicobacter pylori eradication.
abstract: BACKGROUND
  Atrophic gastritis and intestinal metaplasia (IM) are well known as precancerous lesions of gastric cancer. The present study evaluated the gastric mucosa for 10 years after H. pylori eradication at five points of the stomach as recommended by the updated Sydney system to clarify the relationship between H. pylori eradication and gastric cancer prevention.
  
  
  METHODS
  Among the comprised 373 patients, 323 were H. pylori-positive while 50 patients were H. pylori-negative. Patients with successful eradication underwent follow-up endoscopic examination every year. Biopsy specimens were taken from five points of the stomach, as recommended by the updated Sydney system, and were evaluated for the degree of gastritis prospectively.
  
  
  RESULTS
  Two hundred ninety-four out of the 323 H. pylori-positive patients successfully achieved eradication. Of the 197 patients on whom five-point biopsy was performed, the courses of 30 patients were able to be observed every year for 10 years after successful eradication. Inflammation, activity, and atrophy score at all five points were significantly reduced half a year to 6 years after eradication. IM scores fluctuated intensely up and down during all observation periods; however, IM score of the lesser curvature of the corpus continued decreasing gradually and showed a significant decrease 6 years after (0.97 ± 0.09 to 0.42 ± 0.17, P < 0.05).
  
  
  CONCLUSIONS
  In 10 years after H. pylori eradication, atrophy at all sites and IM in the lesser curvature of the corpus gradually and significantly decreased. These results suggest that the improvement of gastric atrophy and IM might have association with the reduction of gastric cancer occurrence.
authors.affiliation: Department of Gastroenterology, Oita University, Hasama-machi, Oita 879-5593, Japan. kodm@oita-u.ac.jp
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kodama
authors.forename: Kazunari
authors.initials: K
authors.lastname: Murakami
authors.forename: Tadayoshi
authors.initials: T
authors.lastname: Okimoto
authors.forename: Ryugo
authors.initials: R
authors.lastname: Sato
authors.forename: Masahiro
authors.initials: M
authors.lastname: Uchida
authors.forename: Takashi
authors.initials: T
authors.lastname: Abe
authors.forename: Seiji
authors.initials: S
authors.lastname: Shiota
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Mizukami
authors.forename: Toshio
authors.initials: T
authors.lastname: Fujioka
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001706:Biopsy; D060740:Disease Eradication; D020776:Endoscopes, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology; D005757:Gastritis, Atrophic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents