Atrophic gastritis and Helicobacter pylori infection in outpatients referred for gastroscopy
- aHerttoniemi Municipal Hospital, FIN-00800 Helsinki, Finland, bDepartment of Pathology, Jorvi Hospital, FIN-02740 Espoo, Finland, cDepartment of Medical Microbiology, University of Oulu, FIN-90220 Oulu, Finland, dDepartment of Bacteriology and Immunology, Haartman Institute, University of Helsinki and Helsinki University Central Hospital Diagnostics, FIN-00014 Helsinki, Finland, eDepartment of Public Health, University of Helsinki, FIN-00300 Helsinki, Finland
- Dr Hilpi Rautelin, Department of Bacteriology and Immunology, PO Box 21, FIN-00014 University of Helsinki, Finland
- Accepted 20 October 1999
BACKGROUND Atrophic gastritis has been shown to be one of the long term sequelae ofHelicobacter pylori infection.
AIMS To determine the prevalence of atrophic gastritis in outpatients, to study the accuracy of serological methods for revealing atrophy, and to define the association of H pylori infection with atrophic gastritis in these patients.
PATIENTS/METHODS A total of 207 consecutive outpatients referred for gastroscopy were included. Biopsy specimens from the antrum and corpus were assessed histologically according to the Sydney system. Serum samples were studied for H pylori IgG and IgA antibodies by enzyme immunoassay, CagA antibodies by immunoblot, pepsinogen I by an immunoenzymometric assay, gastrin by radioimmunoassay, and parietal cell antibodies by indirect immunofluorescence.
RESULTS Histological examination revealed atrophic gastritis in 52 (25%) of 207 patients.H pylori and CagA antibodies were strongly associated with atrophic antral gastritis but poorly associated with atrophic corpus gastritis. Low serum pepsinogen I was the most sensitive and specific indicator of moderate and severe atrophic corpus gastritis. All six patients with moderate atrophic corpus gastritis hadH pylori infection but eight of 10 patients with severe atrophic corpus had increased parietal cell antibodies and nine had no signs of H pyloriinfection.
CONCLUSIONS Atrophic antral gastritis was strongly associated with CagA positiveH pylori infection. Severe atrophic corpus gastritis was not determined by H pyloritests but low serum pepsinogen I, high gastrin, and parietal cell antibodies may be valuable in detecting these changes.
- Helicobacter pylori
- atrophic gastritis
- CagA antibodies
- Helicobacter pylori antibodies
- parietal cell antibodies
- Abbreviations used in this paper:
- H pylori
- Helicobacter pylori
- enzyme immunoassay
- IgA, immunoglobulins G and A