Helicobacter pylorichronic gastritis updated Sydney grading in relation to endoscopic findings and H. pylori IgG antibody: diagnostic methods

Abstract

Helicobacter pylori (Hp) inhabits the stomach of > 50% of humans and has been established as a major etiological factor in the pathogenesis of chronic gastritis, gastric atrophy, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue lymphoma. The aim of this study was to provide unequivocal information about Hp-associated gastritis grading according to the Sydney grading system and to compare the histopathological features with the endoscopic findings and anti-Hp immunoglobulin (Ig)G serological status. This analytical study was conducted on 157 patients with dyspeptic gastritis. All patients underwent esophagogastroduodenoscopy, and antrum and corpus biopsies were taken. Blood samples were obtained from all participants. Different stains were performed on formalin-fixed, paraffin-embedded tissue blocks that included hematoxylin and eosin and Giemsa stain for histopathological interpretation. The endoscopic findings of gastritis were observed in 120 patients and most of them showed hyperemia (80 patients), whereas seven patients had normal appearing gastric mucosa. Histologically variable numbers of mononuclear inflammatory cellular infiltrates were seen in 150 cases (95.5%). Most of them showed Grade 1 gastritis (80 patients), whereas Grades 2 and 3 were found in 43 and 27 biopsies, respectively. Hp colonization was observed in most of the examined biopsies (93.7%). Hp-IgG seropositivity was found in 80.9% of cases and 19.1% were seronegative. The relationship between endoscopic and histological findings was significant (p < 0.001).

Evaluating the spectrum of histomorphological patterns on endoscopic biopsy in patients with upper gastrointestinal tract disorders

“…In the case of gastric biopsies 113 as per the present study 104 (92%) were non neoplastic and only 9 (8%) cases were neoplastic, which is similar to that of the study result of Syed Imtiyaz et al [32] report showed that 57.4% of cases were non neoplastic and 42.6% were neoplastic. In the present study, among the non-neoplastic lesions it was observed that chronic superficial gastritis, 24 common neoplastic lesion were adenocarcinoma which correlated with the present study report.…”

“…However still non-standard histological reporting formats are widely used for gastritis which make it difficult to identify the patients for clinico-endoscopic surveillance. Additionally, there is no validated test to quantify the density of H. Pylori infection [24].…”

High expression of Helicobacter pylori VapD in both the intracellular environment and biopsies from gastric patients with severity

“…We know, that in countries like ours, the H. pylori infection is frequently acquired in childhood and most of the time the disease will develop in adulthood. Early childhood infection typically results in an extended length of infection and likely affords more opportunities for oncogenic mutations [39,40]. Therefore, we believe that vapD presence in H. pylori strains could be a genetic marker for chronicity.…”

Serum IgG antibodies against Helicobacter pylori low molecular weight antigens 50kDa, 30kDa and Urease A 26 kDa, along with vacuolating cytotoxin A are associated with the outcome of the infection

“…There are scarce literature data regarding immunoreactivity to 50kDa antigen. Seroreactivity to 50kDa antigen was significantly more frequent in infected persons with H. pylori than in noninfected ones 31 , in H. pylori line Hpu24 in GCA than in GU ulcer, but it was not the case with line NCT11 and Hcp29 32 . In a study from Turkey, serum antibodies to 50 kDa antigen were not different between GCA patients and patients without cancer 27 .…”