The influence of Helicobacter pylori infection on the progression of gastric mucosal atrophy and occurrence of gastric cancer.

AIM: To study the effects of Helicobacter pylori infection on the progression of gastric mucosal atrophy and the development of gastric cancer. PATIENTS AND METHODS: We investigated the extension of the atrophic area as assessed on the basis of the Kimura-Takemoto atrophic patterns and the development of gastric cancer in a selected sample of 64 patients who were endoscopically followed up for more than 3 years, and who showed H. pylori infection by culture at the start of the investigation and at some stages during the follow-up. RESULTS: No progression of atrophy was observed in 14 patients who were H. pylori-negative at the beginning of the follow-up, whereas various degrees of expansion of the atrophic area were found in 22% of 50 positive cases. Well differentiated mucosal cancer was diagnosed in four patients during the follow-up. These patients displayed moderate to severe atrophy. At the beginning of the follow-up, 50% of patients were H. pylori culture-positive, but all patients had H. pylori antibodies in their blood. CONCLUSIONS: The results support the view that H. pylori infection influences the development of atrophic gastritis and is related to the pathogenesis of gastric cancer.