Helicobacter pylori-associated chronic antral gastritis in Kuwait - A histopathological study

Abstract

In order to study the causal relationship between Helicobacter pylori (HP) and various inflammatory reactions in gastric antral mucosa, we have reviewed 268 endoscopic gastric biopsies in the Department of Pathology of Mubarak Al-Kabeer Teaching Hospital in Kuwait. Of the 219 HP-positive biopsies, 95.4% showed chronic gastritis (CG), 59.8% active chronic gastritis (ACG) and 78.5% lymphoid hyperplasia (LH). The prevalence of LH, CG or ACG, either alone or in combination, increased with increasing density (grade) of HP colonization, assuming statistical significance for LH and ACG (P < 0.05), especially when these changes in Grade 1 HP cases were compared to those of Grades 2 and 3 combined. Moreover, the grade of LH by itself also showed statistically significant correlation (P < 0.01) with the grade of inflammation. Our results confirm a causal relationship between HP colonization of gastric mucosa and the various forms of gastritis, and also provide evidence in support of induction of mucosa-associated lymphoid tissue (MALT) by HP, an observation which may have significance in the genesis of gastric MALTomas.