Gastric Atrophy, Intestinal Metaplasia in <i>Helicobacter pylori</i> Gastritis: Prevalence and Predictors Factors

Abstract

Gastric atrophy and intestinal metaplasia represent the most important premalignant lesions in gastric carcinogenesis. The severity of gastric mucosal inflammation depends on the bacterium Helicobacter pylori (HP)‚ on the host and on environmental factors. The aim of our study is to determine the prevalence and factors associated with Gastric atrophy and intestinal metaplasia in patients infected with Helicobacter pylori. Methods: This is a prospective study over a period of 4 years (May 2009-January 2015) conducted in the service of Hepatology and Gastroenterology in hospital university Hassan II of Fez in collaboration with microbiology and molecular biology laboratory and epidemiology service of Faculty of Medicine and Pharmacy Fes. We included in our study all patients aged over 15 years, having ulcerative dyspepsia, peptic ulcer disease, gastritis or esophagitis. Results: During the study period, 1190 patients were included of which 70% had HP infection (N = 833). The average age was 48.21 years [16-99 years], sex ratio M/F was 1, 11. 60% of patients were older than 45 years. Chronic smoking was found in 12% of patients. Gastric atrophy was observed in 84% (N = 699) of patients infected with HP. Gastric atrophy was localized in 70% in the antrum and 30% in the fundus and 24% in both. The activity of gastritis (p = 0.0001) and the density of the HP (p = 0.005) were factors associated with atrophy. Intestinal metaplasia was observed in 13.5% of patients (N = 112). The density of HP (p = 0.037) and severe atrophy (p = 0.001

Correlations between Endoscopic and Histopathological Assessment of Helicobacter pylori-Induced Gastric Pathology—A Cross-Sectional Retrospective Study

“…The volume of the glands is determined by the volume of the lamina propria, which can be expanded by lymphoplasmacytic element infiltration, especially when there is an associated inflammation. As a result, in chronic active gastritis, determining gland volume is challenging and atrophy is overestimated [6]. The replacement of gastric mucosa by intestinal mucosa is known as intestinal metaplasia.…”