title: High frequency of Helicobacter pylori in the esophageal mucosa of dyspeptic patients and its possible association with histopathological alterations.
abstract: BACKGROUND
  Helicobacter pylori gastric colonization is known to be high in symptomatic subjects. However, only a few reports on the presence of H. pylori in the esophageal mucosa have been published. The aim of this study was to assess the frequency of H. pylori in the esophagus of dyspeptic patients and its association with histopathology.
  
  
  METHODS
  The presence of H. pylori in the gastroesophageal mucosa was detected by fluorescence in situ hybridization (FISH) and PCR analysis of DNA extracted from gastric and esophageal biopsies of 82 symptomatic patients, using genus- and species-specific PCR primers. Alterations in the gastroesophageal mucosa were assessed by conventional histological techniques.
  
  
  RESULTS
  H. pylori in the stomach was detected by PCR and FISH, respectively, in 61% (n=43) and 90% (n=63) of dyspeptic patients, and in the esophagus in 70% (n=44) and 73% (n=46). The prevalence of cagA-positive strains by PCR varied from 50% (n=35) in the gastric mucosa to 65% (n=41) in the esophageal mucosa. By combining the results of both methods, H. pylori was present in the gastroesophageal mucosa in 86% (n=68) of patients. The association of the presence of bacteria, including H. pylori, in the esophageal mucosa with histopathological alterations was statistically significant between microabscesses and bacteria (r=0.656, p<0.0001) and PCR detection and pseudogoblet cells (r=0.25, p<0.047).
  
  
  CONCLUSIONS
  This is the first report of the occurrence of H. pylori in the esophageal mucosa from dyspeptic Venezuelan patients. These results demonstrate the high prevalence of H. pylori in the esophagus, and its presence was correlated with signs of inflammation.
authors.affiliation: Laboratorio de Fisiología Gastrointestinal, Centro de Biofísica y Bioquímica, Instituto Venezolano de Investigaciones Científicas, Km. 11 Carretera Panamericana, Miranda, Venezuela. mocontre@ivic.gob.ve
authors.forename: Monica
authors.initials: M
authors.lastname: Contreras
authors.forename: Víctor
authors.initials: V
authors.lastname: Salazar
authors.forename: María Alexandra
authors.initials: MA
authors.lastname: García-Amado
authors.forename: Nelson
authors.initials: N
authors.lastname: Reyes
authors.forename: Miguel
authors.initials: M
authors.lastname: Aparcero
authors.forename: Olga
authors.initials: O
authors.lastname: Silva
authors.forename: Denny
authors.initials: D
authors.lastname: Castro
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Pulchérie
authors.initials: P
authors.lastname: Gueneau
authors.forename: Fabián
authors.initials: F
authors.lastname: Michelangeli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004415:Dyspepsia / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D004947:Esophagus / Q000382:microbiology* / Q000473:pathology; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D009092:Mucous Membrane / Q000382:microbiology / Q000473:pathology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D013270:Stomach / Q000382:microbiology / Q000473:pathology; D055815:Young Adult