TISSUE-STAINING FOR HELICOBACTER-PYLORI IN INTESTINAL METAPLASIA - CORRELATION WITH ITS EXTENSION AND HISTOCHEMICAL SUBTYPES

The role played by Helicobacter pylori (Hp) infection in the occurrenc e of non-cardial gastric adenocarcinoma is suggestive but still debate d, This study aimed to evaluate: a) the prevalence of Helicobacter-lik e organisms in antral bioptic specimens of 291 patients with chronic g astritis with antral atrophy and different subtypes of intestinal meta plasia (IM); b) the presence of a possible different positive tissue s taining for the bacteria in the complete and incomplete intestinal met aplasia. Of the 291 patients, 222 cases (76.3%) showed type I IM, 28 c ases (9.6%) type II IM and 41 cases (14.1%) type III IM. Helicobacter- like organisms were found in 42.9% of cases and positive tissue staini ng rate appeared to be inversely related to the extension of IM (58.7 % in IM extended in less than 30% of specimens, 30.2% in IM extended b etween 30% and 60%, 2.7% in IM exceeding 60% of the biopsed area). The inverse correlation between lower positive tissue staining for Helico bacter-like organisms and greater extension of IM was statistically si gnificant (p < 0.001). Incomplete metaplasia appeared to be unrelated to age and associated with a lower positive tissue staining for Helico bacter-like organisms; among patients with type I metaplasia, 118/222 showed Hp-positive bioptic specimens, vs 7/69 of types II and III (p < 0.001). In conclusion, positive tissue staining for Helicobacter-like organisms appeared to be significantly (p < 0.001) higher in type I I M, vs types II and III, and to a lesser extent to metaplastic changes; in addition, when metaplastic changes are not greatly extended (less than 30%), the presence of the bacteria is significantly reduced in sp ecimens with incomplete form of intestinal metaplasia in comparison wi th the complete one.