Differing Patterns of Helicobacter pylori Gastritis in Patients with Duodenal, Prepyloric, and Gastric Ulcer Disease

Background: We investigated the risk relationship between histotopographic patterns of Helicobacter pylori gastritis and peptic ulcer site. Methods: Three hundred and eighty-three infected patients were classified as having duodenal ulcer (n = 79), prepyloric ulcer (n = 39), gastric (angular) ulcer...

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Bibliographic Details
Published in:Scandinavian journal of gastroenterology 1998, Vol.33 (2), p.137-142
Main Authors: Schultze, V, Hackelsberger, A, Günther, T, Miehlke, S, Roessner, A, Malfertheiner, P
Format: Article
Language:English
Subjects:
Atrophy
Biological and medical sciences
Duodenal Ulcer - pathology
Gastric Mucosa - pathology
Gastritis - microbiology
Gastritis - pathology
Gastroenterology. Liver. Pancreas. Abdomen
Helicobacter Infections - pathology
Helicobacter pylori
Humans
Intestinal Mucosa - pathology
Medical sciences
Other diseases. Semiology
Risk
Sex Distribution
Stomach Ulcer - pathology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
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Summary:Background: We investigated the risk relationship between histotopographic patterns of Helicobacter pylori gastritis and peptic ulcer site. Methods: Three hundred and eighty-three infected patients were classified as having duodenal ulcer (n = 79), prepyloric ulcer (n = 39), gastric (angular) ulcer (n = 28), and no ulcer (n = 237). Antral and corpus biopsy specimens were taken. Sydney system-based scores for bacterial density and activity and degree of gastritis were added to antral and corpus sum scores (SS) (range, 0-9). These were used to categorize the phenotype of gastritis. In addition, the presence or absence of mucosal atrophy was taken into account. The relative risk for ulcer association with these conditions was calculated. Results: High-grade antral (SS > 5) associated with mild to moderate corpus (SS > 5) gastritis increased duodenal (RR = 4.9; confidence interval (CI), 2.8-8.5) and prepyloric ulcer risk (RR = 2.99; CI, 1.4-6.2). High-grade gastritis in the antrum (SS > 5) and corpus (SS > 5) increased gastric ulcer risk (RR = 3.7; CI, 1.6-8.3). Antral atrophy and/or intestinal metaplasia is associated with an increased gastric ulcer risk (RR = 3.3; CI, 1.4-7.8). Conclusion: The pattern of H. pylori gastritis may define a risk for peptic ulcer at various sites, but additional factors, not reflected in histology, also contribute to this risk.
ISSN:0036-5521
1502-7708
DOI:10.1080/00365529850166851