Atrophic gastritis and intestinal metaplasia in helicobacter pylori-associated antral gastritis

Abstract

Although the causal relationship between Helicobacter pylori (H. pylori) infection and chronic gastritis and peptic ulcer disease appears established, the relationship between the organism and gastric carcinoma remains tenuous. We have reviewed 268 gastric antral biopsies from the Department of Pathology, Mubarak Al-Kabeer Hospital, Kuwait, in an attempt to assess the relationship between H. pylori colonizations and the presence of atrophic gastritis and intestinal metaplasia, recognized premalignant lesions of the stomach. H. pylori were found in 219 (81.7%) patients of which 62 (28.3%) had atrophic gastritis and 33 (15.1%) intestinal metaplasia. Both atrophic gastritis and intestinal metaplasia increased with age. The mean age of patients with intestinal metaplasia was about 8 years older than that of patients without intestinal metaplasia. Higher prevalences of both lesions were associated with lower density H. pylori colonization as well as an increasing grade of chronic inflammation. Our results confirm previous findings of a probable causal relationship between H. pylori infection and both atrophic gastritis and intestinal metaplasia. The higher prevalence of these premalignant lesions in older subjects would suggest progressive changes associated with persistent H. pylori infection.