RELATIONSHIP BETWEEN PROGRESSION OF GASTRIC-MUCOSAL ATROPHY AND HELICOBACTER-PYLORI INFECTION - RETROSPECTIVE LONG-TERM ENDOSCOPIC FOLLOW-UP-STUDY

A retrospective long-term endoscopic followup study was designed to ex amine atrophic changes in the gastric mucosa over time in Helicobacter pylori-positive patients. Over a period of 8-17 years (mean, 13.4 yea rs) 22 subjects (5 men, 17 women, mean age, 55 years) without localize d gastroduodenal lesions underwent serial endoscopic examinations and serological and microbiological assessments df H. pylori infection. Th e extent of atrophic mucosa in the gastric body was expressed using th e Kimura-Takemoto classification of atrophic pattern. Atrophic pattern s were unchanged over time in 7 H. pylori-seronegative and culture-neg ative subjects with normal stomach, and in 1 seropositive and culture- negative subject with severe atrophy. Seven of 10 H. pylori culture-po sitive subjects not including three with the O-3 pattern, i.e., open t ype atrophic pattern, exhibited a cephalad shift of atrophic pattern. The cumulative progression rates of atrophy in the culture-positive su bjects excluding O-3 subjects, were 10% after 2 years, 20% after 4 yea rs, 50% after 6 years, and 70% after 8 years. The increases in the ext ent of the atrophic area were discontinuous, in terms of age, in the H . pylori-positive individuals and occasionally advanced rapidly within periods of several years with no relation to age.