Helicobacter pylori in promotion of gastric carcinogenesis

Massimo Rugge, Mauro Cassaro, Gioacchino Leandro, Raffaele Baffa, Claudio Avellini, Pantaleone Bufo, Vincenzo Stracca, Giuseppe Battaglia, Alfredo Fabiano, Antonio Guerini, Francesco Di Mario

Research output: Contribution to journalArticlepeer-review


Gastric atrophy and intestinal metaplasia are considered the earliest phenotypic changes in the cascade of events leading from normal mucosa to intestinal-type gastric cancer, and epidemiological evidence links Helicobacter pylori to gastric epithelial malignancies. To evaluate any causal relationship between bacterial infection and atrophic metaplastic lesions, gastric pathology was histologically and histochemically evaluated in 267 consecutive, nonulcerous, untreated subjects, with attention given to the phenotypes of intestinal metaplasia. The prevalence of Helicobacter pylori infection was 61%. Intestinal metaplasia (particularly types II and III) was significantly associated with both Helicobacter pylori detection (χ(LR)2: P <0.002) and increasing age (χ(LR)2: P <0.002). Using logistic regression analysis, the development of intestinal metaplasia proved more significantly linked with Helicobacter pylori infection [odds ratio = 4.55 (95% confidence interval: 1.51-13.7)], than with age [odds ratio = 1.03 (95% CI: 1.01-1.06)], with no interaction. In conclusion, Helicobacter pylori can be considered among the major causal agents of mucosal lesions involved in the multistep process of gastric carcinogenesis, justifying any attempt to eradicate this bacterial infection.

Original languageEnglish
Pages (from-to)950-955
Number of pages6
JournalDigestive Diseases and Sciences
Issue number5
Publication statusPublished - 1996


  • atrophic gastritis
  • gastric precancer
  • Helicobacter pylori
  • intestinal metaplasia
  • mucin histochemistry
  • multifocal atrophic gastritis

ASJC Scopus subject areas

  • Gastroenterology


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