Objectives: To assess the incidence of Helicobacter pylori colonization in early gastric cancer and to study the effects of this bacterium on the pathogenesis of gastritis and cancer. Design: We studied the early stages of gastric cancer in order to obtain more information on carcinogenesis. Different sampling procedures were used in an attempt to explain the widely diverging figures on H. pylori colonization that have so far been reported in gastric cancer. Methods: Mucosal samples were taken from the whole lesser and greater gastric curves and from peritumour, antral, corpus or resection margins, using surgical specimens from 228 patients with gastric cancer (167 early and 61 advanced) and 91 patients without cancer. Endoscopic biopsies from cancerous and non-cancerous patients were also investigated. H. pylori were stained with Giemsa and immunoperoxidase. Gastritis was scored according to the Sydney system. Results: H. pylori was detected in the gastric mucosa of 137 of 167 (82%) cases of early cancer, including 100% of 47 diffuse, 72% of 99 glandular (intestinal) and 90% of 21 mixed tumours. Lower rates were found in diffuse cancer at an advanced stage. Unlike the ulcer patients, whether dyspeptic or asymptomatic, the cancer patients showed a much lower H. pylori incidence in the antrum than in the corpus, especially in samples from glandular cancer and in biopsy samples. Conclusions: The high rates of H. pylori colonization found in the early stages of cancer suggest that this bacterium contributes to the pathogenesis of gastric cancer, through chronic active gastritis, with or without glandular atrophy, intestinal metaplasia or dysplasia, and ending preferentially in glandular or diffuse cancer, respectively.
|Journal||European Journal of Gastroenterology and Hepatology|
|Issue number||SUPPL. 2|
|Publication status||Published - 1993|
- Gastric cancer
- Helicobacter pylori
ASJC Scopus subject areas