HELICOBACTER-PYLORI INFECTION IN PATIENTS WITH GASTRIC-CARCINOMA IN BIOPSY AND SURGICAL RESECTION SPECIMENS

BACKGROUND. The discrepancy between the high seropositivity for Helico bacter pylori (H. pylori) and the low diagnostic yield of H. pylori or ganism in gastric biopsies of patients with gastric carcinoma has yet to be clarified. The present study attempted to clarify this controver sial point by performing a comparative evaluation between the detectio n rate of H. pylori in biopsy and in surgical specimens. METHODS. The presence of H. pylori in biopsy samples from 50 patients with gastric carcinoma and 50 age-matched controls was evaluated histologically. Si x histologic sections were obtained from gastric noncancerous areas an d the presence of H. pylori was evaluated in those H. pylori negative patients who underwent gastrectomy. RESULTS. H. pylori was positive in 35 of 50 controls (70%). In biopsy samples, H. pylori was detected in 29 of 37 patients (78.4%) with early gastric carcinoma, 7 of 13 (53.8 %) with advanced carcinoma, 16 of 23 (69.6%) with intestinal type of g astric carcinoma, and 20 of 27 (74.1%) with diffuse type of carcinoma. Studies carried out in gastrectomy specimens increased the diagnostic yield of H. pylori to 33 (89.2%), 12 (92.3%), 19 (82.6%), and 26 (96. 3%) in patients with early, advanced, intestinal, and diffuse types of gastric carcinoma, respectively. Overall, H. pylori was positive in 3 6 biopsy specimens (72%) and 45 gastrectomy specimens (90%). Namely, t he detection of H. pylori infection was significantly higher in patien ts with gastric carcinoma using gastrectomy specimens than in patients with gastric carcinoma using biopsy specimens only (P < 0.05). CONCLU SIONS. These results indicate that the actual prevalence of H. pylori in patients with gastric carcinoma is considerably higher than that pr eviously reported. (C) 1996 American Cancer Society.