HELICOBACTER-PYLORI INFECTION AND ADENOCARCINOMA ARISING IN BARRETTS-ESOPHAGUS

Helicobacter pylori infection has been implicated in the development o f chronic active gastritis and gastric neoplasms (ie, mucosa-associate d lymphoid tumors and adenocarcinoma). The potential association betwe en esophageal H pylori infection with Barrett's esophagus-associated a denocarcinoma has not been previously studied. Nineteen cases of adeno carcinoma arising in Barrett's esophagus were examined for the presenc e of H pylori. Barrett's esophagus was defined by the presence of meta plastic specialized-type epithelium (gastric-type epithelium with gobl et cell metaplasia) in the distal esophagus. To detect the presence of H pylori, 5-mu m sections, from several tissue blocks in each case, w ere stained with routine hematoxylin-eosin, modified Giemsa, and an an tibody directed against H pylori (Dako a/s, Denmark, Lot # 111061). St ained sections were examined independently by two pathologists. All th ree staining methods failed to show H pylori in any of the cases exami ned. Sections of Barrett's esophagus (with and without dysplasia), ade nocarcinoma, and stomach (when available) were uniformly negative for the presence of H pylori. We conclude that neither gastric nor esophag eal infection with H pylori is a requisite for the development of aden ocarcinoma in Barrett's esophagus. Moreover, it is unlikely that a sig nificant association between H pylori infection and Barrett's-associat ed adenocarcinoma exists. Copyright (C) 1997 by W.B. Saunders Company.