Helicobacter Pylori Serology in Chronic Gastritis with Antral Atrophy and Negative Histology for Helicobacter-Like Organisms

Testoni, P.A.; Colombo, Elena; Cattani, Laila; Longhi, M. Paula; Bagnolo, F.; Lella, F.; Buizza, M.; Scelsi, R

doi:10.1097/00004836-199604000-00006

Cited by 28 publications

(18 citation statements)

References 20 publications

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“…In contrast, this tendency did not appear in the controls [26]. In addition, atrophic gastritis and IM were determined to be hostile conditions for H. pylori colonization, making the sensitivity of these nonserologic methods low [9,12,[14][15][16][17]19]. In this background the current study was performed to evaluate the meaning of anti-H. pylori IgG positivity when CLOtest, histological test, and culture in the antrum and body are all negative.…”

Section: Discussionmentioning

confidence: 99%

“…Culture and rapid urease tests are known to be less sensitive than histology [9][10][11][12]. However, when atrophic or metaplastic changes occur in the gastric mucosa, a high percentage of endoscopic biopsy samples give negative bacterial histology [13,14], suggesting that the role of H. pylori could be underestimated if only nonserologic methods are used in detecting H. pylori infection [14][15][16][17]. Therefore, when H. pylori is difficult to detect by histology or no longer exists in gastric mucosa due to the progression of atrophy and IM, serology can be more sensitive for the detection of current or past infection with H. pylori.…”

Section: Abstract Helicobacter Pylori Serology Atrophic Gastritismentioning

confidence: 99%

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Progression of Atrophic Gastritis and Intestinal Metaplasia Drives Helicobacter pylori Out of the Gastric Mucosa

et al. 2006

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This study was performed to evaluate the implication of anti-H. pylori IgG positivity when CLOtest, histological test, and culture in the antrum and body are all negative, and to find out the specific disease category that is more affected by the hostile relationship of atrophic gastritis and intestinal metaplasia (IM) with H. pylori. Four hundred thirty-six patients (84 controls, 69 with duodenal ulcer, 96 with benign gastric ulcer, 43 with dysplasia, 144 with gastric cancer), who had not received any eradication therapy, were divided into three groups according to H. pylori test: CLOtest or histological H. pylori-positive group (group A; 294 cases), only anti-H. pylori IgG-positive group (group B; 62 cases), and anti-H. pylori IgG-negative group (group C; 80 cases). The grade of neutrophil and monocyte infiltration, atrophic gastritis, and IM was compared according to the updated Sydney system classification. Neutrophil and monocyte infiltrations were significantly severe in the group A. In contrast, the grade of atrophic gastritis and IM in the antrum was significantly higher in group B than the other two groups, A or C. When patients were divided according to the disease outcome in each group, the grade of IM in the body was statistically higher only in the patients with cancer or dysplasia in group B. These results suggest that anti-H. pylori IgG positivity with all negative invasive H. pylori tests represents past infection with H. pylori rather than a false negative, especially in the case of dysplasia and gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Abstract Helicobacter Pylori Serology Atrophic Gastritismentioning

confidence: 99%

Progression of Atrophic Gastritis and Intestinal Metaplasia Drives Helicobacter pylori Out of the Gastric Mucosa

et al. 2006

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“…Além disso, a falha na identificação da bactéria é significativa nos casos em que porções extensas de mucosa atrófica ou metaplásica estão presentes. A MI deve ser considerada condição que marcadamente reduz a chance de identificação do H. pylori em biopsias, mesmo quando é coletado grande número de amostras, como sugerido pelo sistema Sydney (38) . Essa pode ser uma razão que explicaria o fato da infecção pelo H. pylori não ter determinado risco para a ocorrência de GA e MI neste grupo de pacientes.…”

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Prevalência da infecção por Helicobacter pylori e das lesões precusoras do câncer gástrico em pacientes dispéticos

Müller

Fagundes

Moraes

et al. 2007

Arq. Gastroenterol.

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RESUMO -Racional -A infecção pelo Helicobacter pylori é fator importante no desenvolvimento da carcinogênese gástrica, mas somente uma fração dos pacientes infectados irá desenvolver câncer gástrico. A infecção pelo H. pylori determina gastrite crônica não-atrófica, que pode evoluir para gastrite atrófica e metaplasia intestinal e, finalmente, para displasia e adenocarcinoma. , 3% e 15% das biopsias, respectivamente. A infecção por H. pylori determinou uma razão de chances 10 vezes (IC95% 6.50 -17%) maior de se encontrar algum grau de alteração histológica na mucosa gástrica. A razão de chances dos pacientes infectados apresentarem gastrite crônica não-atrófica, foi igual a 3 (IC95% 2,2 -3,4). A razão de chances dos pacientes infectados apresentarem gastrite atrófica e metaplasia intestinal foi menor que 1. Conclusão -A prevalência da infecção por H. pylori foi alta (76%) e os indivíduos infectados apresentaram probabilidade 10 vezes maior para a ocorrência de lesão da mucosa gástrica. Gastrite crônica não-atrófica apresentou prevalência de 77%, gastrite atrófica 3% e metaplasia intestinal 15%. A infecção pelo H. pylori determinou uma probabilidade 3 vezes maior para o desenvolvimento de gastrite crônica não-atrófica e não determinou risco para a ocorrência de gastrite atrófica e metaplasia intestinal, sugerindo que possivelmente outros fatores de risco, além do H. pylori, estejam envolvidos no processo da carcinogênese gástrica. DESCRITORES -Infecções por Helicobacter. Neoplasias gástricas. Condições pré-cancerosas. Dispepsia. INTRODUÇÃOO câncer gástrico é a segunda causa mais comum de morte por câncer no mundo e quase dois terços dos casos ocorrem em países em desenvolvimento (28) . Progresso significante na etiologia do câncer gástrico foi a identificação do Helicobacter pylori (H. pylori) e as evidências acumuladas que levaram a sua classificação como fator importante ligado ao processo da carcinogênese gástrica. No entanto, tem-se observado grande heterogeneidade entre as populações, no que diz respeito ao risco do desenvolvimento de câncer gástrico associado à infecção pelo H. pylori, notando-se que nas populações com alta prevalência da infecção somente uma fração da mesma irá desenvolver câncer gástrico (15) .Estudos da mucosa gástrica em populações de alto risco têm revelado uma série de lesões que, seqüencialmente, evoluiriam da condição normal para gastrite crônica não-atrófica (GCNA), que evoluiria para gastrite atrófica (GA) e metaplasia intestinal (MI) e, finalmente, para displasia e adenocarcinoma (7,8,10,35) . Portanto, a infecção pelo

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“…Of infected individuals, 2 to 7% show an elevated level of IgA antibody only (5,9). Patients with atrophic corpus gastritis often have positive helicobacter serology, although microscopic examination (6,22), culture of biopsy samples, and even the urea breath test remain helicobacter negative (8). These particular patients may still be infected, as shown by rapidly falling antibody titers after therapy (7).…”

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confidence: 99%

Age-Dependent Accuracy of Helicobacter pylori Antibody Assays for Adults, with Special Emphasis on Atrophic Gastritis

Salomaa-Räsänen

Kosunen

Mattila

et al. 2004

Clin Vaccine Immunol

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The accuracy of Helicobacter pylori antibody assays for 561 consecutive adult outpatients who had undergone gastroscopy was studied. The sensitivity of an immunoglobulin G test was 99 to 100% for all age groups, but the specificity declined by age group, from 99% for those aged 15 to 49 years to 75% for those aged >65 years. The exclusion of false-positive results for patients with atrophic gastritis improved the specificity to 93 to 97% for the older age groups.Helicobacter pylori infection is associated with gastritis, peptic ulcer disease, and gastric malignancies (1). In about onethird or up to one-half of those infected with H. pylori, gastritis proceeds to atrophic gastritis, resulting in a loss of mucosal glands, decreased helicobacter colonization and, when affecting the corpus mucosa, decreased secretion of pepsinogen I (PGI) (10, 23).Most helicobacter-infected subjects have specific circulating immunoglobulin G (IgG) antibodies. However, IgA antibodies are found in approximately two-thirds of infected subjects (9). Of infected individuals, 2 to 7% show an elevated level of IgA antibody only (5, 9). Patients with atrophic corpus gastritis often have positive helicobacter serology, although microscopic examination (6, 22), culture of biopsy samples, and even the urea breath test remain helicobacter negative (8). These particular patients may still be infected, as shown by rapidly falling antibody titers after therapy (7).Enzyme immunoassay (EIA) is the most commonly used serological method for detecting antibodies to H. pylori. The best commercial kits have shown sensitivities and specificities of 90% to in excess of 95% (3, 12 Biopsy samples. Gastroscopies were performed by one of the authors (A.S.-R.) in a routine manner, with two biopsies from the gastric antrum (2 cm or more from the pylorus), two biopsies from the large curve of the gastric corpus for histological examination, and additional biopsies (one from the antrum and one from the corpus) for culture.Formalin-fixed biopsy specimens were embedded in paraffin. Tissue sections of 3 m were cut at three levels per biopsy and placed on one slide. The tissue sections were stained with hematoxylin and eosin, Alcian blue (pH 2.5)-periodic acidSchiff, and modified Giemsa. Gastritis was classified according to the Sydney System, in a blinded fashion, by one pathologist (J.M.) (20).The biopsies were mailed for culture in Transpocult tubes (Orion Diagnostica, Espoo, Finland). The specimens were cultured for H. pylori for up to 12 days on Brucella agar plates (Becton Dickinson, Sparks, Md.) (18) supplemented with whole horse blood (7%) and on selective Brucella agar plates containing Iso-Vitalex (1%), vancomycin (6 mg/liter), amphotericin B (2 mg/liter), and nalidixic acid (20 mg/liter).Results were considered helicobacter positive if culture or histology or both were positive.Serum tests. Serum samples were taken during each patient's visit to the endoscopic unit and were stored at Ϫ20°C until analyzed. Sera were tested for H. pylori IgG and IgA antibodie...

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Helicobacter Pylori Serology in Chronic Gastritis with Antral Atrophy and Negative Histology for Helicobacter-Like Organisms

Cited by 28 publications

References 20 publications

Progression of Atrophic Gastritis and Intestinal Metaplasia Drives Helicobacter pylori Out of the Gastric Mucosa

Progression of Atrophic Gastritis and Intestinal Metaplasia Drives Helicobacter pylori Out of the Gastric Mucosa

Prevalência da infecção por Helicobacter pylori e das lesões precusoras do câncer gástrico em pacientes dispéticos

Age-Dependent Accuracy of Helicobacter pylori Antibody Assays for Adults, with Special Emphasis on Atrophic Gastritis

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