LACK OF ASSOCIATION BETWEEN HELICOBACTER-PYLORI AND GASTRIC ATROPHY OR INTESTINAL METAPLASIA IN ELDERLY PATIENTS

Helicobacter pylori (Hp) is associated with gastritis and peptic ulcer s. It may also induce gastric atrophy (GA) and intestinal metaplasia ( IM), and these changes may be the precursors of gastric carcinoma. The aim of this study was to determine if GA or IM is associated with Hp infection in elderly patients. Consecutive patients admitted for gastr oscopy were recruited. Multiple biopsies were taken for histology and rapid urease (CLO) tests along with IgG enzyme-linked immunosorbent as say antibodies and C-13-urea breath tests. Statistical analysis was by chi(2) tests. 114 patients were recruited, the average age was 78.9 /- 5.4 years. Histology was available on 105 patients, 80 (76.2%) had gastritis, and 61/80 (76.25%) had evidence of definite current Hp infe ction. Seven patients had reflux gastritis, and these were excluded fr om the analysis described below. 20 patients had GA and 24 IM. The rel ationship between Hp and GA or IM was investigated by dividing patient s into four groups: Group 1 patients (n = 57) were taken to be definit ely currently infected (GA 7 patients, IM 11, both 1). Group 2 patient s (n = 18) had old infection (GA 2, IM 4, both 3). Group 3 patients (n = 16) have never been infected previously (GA1, IM 1, both 3). Group 4 patients (n = 4) had a poor immunological response to Hp (GA 1, IM I , both 0). There were no significant differences in the numbers of pat ients with GA or IM in any group as compared with any other, with the exception of less patients with histological evidence of combined GA a nd IM among patients with definite current infection as compared with those with either previous infection (p = 0.04) or 'never' infection ( p = 0.03). We conclude that the mucosal changes of GA or IM are not co nsistently associated with Hp infection in the elderly.