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Helicobacter pylori in promotion of gastric carcinogenesis

  • Esophageal, Gastric, And Duodenal Disorders
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Abstract

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 linksHelicobacter 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 ofHelicobacter pylori infection was 61%. Intestinal metaplasia (particularly types II and III) was significantly associated with bothHelicobacter pylori detection (x 2LR :P<0.002) and increasing age (x 2LR :P<0.002). Using logistic regression analysis, the development of intestinal metaplasia proved more significantly linked withHelicobacter 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.

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References

  1. Lauren P: The two histological main types of gastric carcinoma: Diffuse and so-called intestinal type carcinoma. An attempt at a histoclinical classification. Acta Pathol Microbiol Scand 64:31–49, 1965

    Google Scholar 

  2. Correa P: Human gastric carcinogenesis: A multistep and multifactorial process. Cancer Res 52:6735–6740, 1992

    Google Scholar 

  3. Correa P:Helicobacter pylori and gastric carcinogenesis. Am J Surg Pathol 19(1):37–43, 1995

    Google Scholar 

  4. Marshall BJ:Helicobacter pylori. Am J Gastroenterol 89:s116-s128, 1994

    Google Scholar 

  5. Parsonnet J, Friedman GD, Vandersteen DP, Chang Y, Volgeman JH, Orentreich N, R Sibley:Helicobacter pylori infection and risk of gastric cancer. N Engl J Med 325:1127–1131, 1991

    Google Scholar 

  6. Nomura A, Stemmermann GN, Chyou P, Kato I, Perez-Perez GI, Blaser MJ:Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii. N Engl J Med 325:1132–1136, 1991

    Google Scholar 

  7. Correa P: Is gastric carcinoma an infectious disease? N Engl J Med 325:1170–1171, 1991

    Google Scholar 

  8. Mohandas KM:Helicobacter pylori and gastric lymphoma. N Engl J Med 331:746, 1994

    Google Scholar 

  9. Correa P, Fox J, Fontham E, Ruiz B, Lin Y, Zavala D, Taylor M, Mackinley D, Del Lima E, Portilla H, Zarama G:Helicobacter pylori and gastric carcinoma. Serum antibodies prevalence in populations with contrasting risks. Cancer 66:2569–2574, 1990

    Google Scholar 

  10. Olive C, Michault A, Brassens-Rabbe MP, Megraud F: Seroepidemiology ofCampylobacter pylori in Reunion Island. Klin Wochenschr 67:52, 1989 (abstract)

    Google Scholar 

  11. Craanen ME, Blok P, Ferwerda J, Tygtat GNJ: Subtypes of intestinal metaplasia andHelicobacter pylori. Gut 33:597–300, 1992

    Google Scholar 

  12. Rugge M, DiMario F, Cassaro M, Baffa R, Farinati F, Rubio J Jr, Ninfo V: Pathology of the gastric antrum and body associated with Helicobacter pylori infection in non-ulcerous patients: Is the bacterium a promoter of intestinal metaplasia? Histopathology 22:9–15, 1993

    Google Scholar 

  13. Eidt S, Stolte M: Prevalence of intestinal metaplasia inHelicobacter pylori gastritis. Scand J Gastroenterol 29:607–610, 1994

    Google Scholar 

  14. Correa P, Shiao YH: Phenotypic and genotypic events in gastric carcinogenesis. Cancer Res (Suppl) 54:1941s-1943s, 1994

    Google Scholar 

  15. Yardley JH: Pathology of chronic gastritis and duodenitis.In Gastrointestinal Pathology. H Goldman, HD Appelman, N Kaufman (eds). Baltimore, Williams & Wilkins, 1990, pp 69–143

    Google Scholar 

  16. Price A: The Sydney System: Histological division. J Gastroenterol Hepatol 6:209–222, 1991

    Google Scholar 

  17. Spicer SS: Diamine methods for differentiating mucosubstances histochemically. J Histochem Cytochem 13:211–234, 1965

    Google Scholar 

  18. Jass JR, Filipe MI: The mucin profile of gastric mucosa, intestinal metaplasia and gastric carcinoma. Histochem J 13:931–939, 1981

    Google Scholar 

  19. Filipe MI, Barbatis C, Sandey A, Ma J: Expression of intestinal mucin antigens in the gastric epithelium and its relationship with malignancy. Hum Pathol 19:19–26, 1988

    Google Scholar 

  20. Whitehead R: Mucosal Biopsy of the Gastrointestinal Tract, 3rd ed. Philadelphia, Saunders, 1985

    Google Scholar 

  21. Correa P: Chronic gastritis. A clinico-pathologic classification. Am J Gastroenterol 83:504–509, 1988

    Google Scholar 

  22. Silva S, Filipe MI, Pinho A: Variants of intestinal metaplasia in the evolution of chronic atrophic gastritis and gastric ulcer. A follow-up study. Gut 31:1097–1105, 1990

    Google Scholar 

  23. Andrew A, Wyatt JI, Dixon MF: Observer variation in the assessment of chronic gastritis according to the Sydney system. Histopathology 25:317–322, 1994

    Google Scholar 

  24. Fleiss JL: Statistical Methods for Rates and Proportions, 2nd ed. New York, Wiley, 1981

    Google Scholar 

  25. Rugge M, Farinati F, Baffa R, Sonego F, DiMario F, Leandro G, Valiante F: Gastric epithelial dysplasia in the natural history of gastric cancer: A multicenter prospective follow-up study. Gastroenterology 107:1288–1296, 1994

    Google Scholar 

  26. Filipe MI, Jass JR: Intestinal metaplasia sub-types and cancer risk.In Gastric Carcinoma. MI Filipe and JR Jass (eds). Edinburgh, Churchill Livingstone, 1986, pp 87–115

    Google Scholar 

  27. Fiocca R, Villani L, Luinetti O, Giannatti A, Perego M, Alvisi C, Turpini F, Solcia E:Helicobacter colonization and histopathological profile of chronic gastritis in patients with and without dyspepsia, mucosal erosion and peptic ulcer: A morphological approach to the study of ulcerogenesis in man. Virchows Arch A (Pathol Anat) 420:489–498, 1992

    Google Scholar 

  28. Kawano S, Tsujii M, Nagano K, Ogihara T, Taminura H, Nayashi N, Ito T, Sato N, Kamada T, Tamura K: Different effect ofHelicobacter pylori on the human gastric antral and body mucosal intracellular mucin. Scand J Gastroenterol 25:997–1003, 1990

    Google Scholar 

  29. Stole M, Ohnsmann A: Differences inHelicobacter pylori associated gastritis in the antrum and body of the stomach. Z Gastroenterol 28:220–233, 1990

    Google Scholar 

  30. Genta RM, Lew GM, Graham DY: Changes in the gastric mucosa following eradication ofHelicobacter pylori. Mod Pathol 6(3):281–289, 1993

    Google Scholar 

  31. Satoh K, Kimura K, Yoshida Y, Kasano T, Kihira K, Taniguchi Y: A topographical relationship betweenHelicobacter pylori and gastritis: Quantitative assessment of Helicobacter pylori in the gastric mucosa. Am J Gastroenterol 86(3):285–291, 1991

    Google Scholar 

  32. Shiao YH, Rugge M, Correa P, Lehmann HP, Scheer D: p53 alteration in gastric precancerous lesions. Am J Pathol 144:511–517, 1994

    Google Scholar 

  33. Strickland RG, Mackay IR: A reappraisal of the nature and significance of chronic atrophic gastritis. Am J Dis Sci 18:426–440, 1973

    Google Scholar 

  34. Guarner J, Mohar A, Parsommet J, Halperin D: The association ofHelicobacter pylori with gastric cancer and preneoplastic lesions in Chiapas, Mexico. Cancer 72(2):297–301, 1993

    Google Scholar 

  35. Decarli A, La Vecchia C, Cislaghi C, Mezzanotte G, Marubini E: Descriptive epidemiology of gastric cancer in Italy. Cancer 58:2560–2569, 1986

    Google Scholar 

  36. Parkin DM, Pisani P, Ferlay J: Estimates of the worldwide incidence of eighteen major cancers in 1985. Int J Cancer 54:594–606, 1993

    Google Scholar 

  37. Decarli A, La Vecchia C: Cancer mortality in Italy 1990: Tumori 80:12–18, 1994

    Google Scholar 

  38. Logan RPH:Helicobacter pylori and gastric cancer. Lancet 334:1078–1079, 1994

    Google Scholar 

  39. Parsonnet J, Hansen S, Friedman GD:Helicobacter pylori and gastric lymphoma. N Engl J Med 331:746, 1994 (letter)

    Google Scholar 

  40. Rugge M, Farinati F, DiMario F: Can we justify resecting all gastric epithelial dysplastic lesions? Gastroenterology 108: 1955–1956, 1995

    Google Scholar 

  41. Rugge M, Leandro G, Farinati F, Di Mario F, Sonego F, Cassaro M, Guido M, Ninfo V: Gastric epithelial dysplasia: How clinicopathologic background relates to management. Cancer 76:376–382, 1995

    Google Scholar 

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Rugge, M., Cassaro, M., Leandro, G. et al. Helicobacter pylori in promotion of gastric carcinogenesis. Digest Dis Sci 41, 950–955 (1996). https://doi.org/10.1007/BF02091536

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  • DOI: https://doi.org/10.1007/BF02091536

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