MINIMAL CHRONIC INACTIVE GASTRITIS - INDICATOR OF PREEXISTING HELICOBACTER-PYLORI GASTRITIS

Minimal chronic inactive gastritis is regularly observed in routine hi stopathology. Presently, it is not clear whether this type of gastriti s should be regarded as a histopathological entity or a normal variant . The similarity so lesions observed after H. pylori eradication promp ted Ms to look for an association between minimal chronic inactive gas tritis and status post H. pylori eradication. In a prospective study o f 110 consecutive patients undergoing upper gastrointestinal endoscopy , at least two mucosal biopsies were taken from the gastric antrum and body. Gastritis was classified according to the Sydney System, Antibo dies to H. pylori were determined serologically by immunofluorescence test, ELISA, and complement binding reaction. A status post eradicatio n of H. pylori was revealed by medical history and/or positive serolog y; H. pylori gastritis was found in 39.1%, reactive gastritis in 12.7% , and minimal chronic inactive gastritis in 29.1%. rn 19.1% a combinat ion of reactive/minimal chronic gastritis was diagnosed according to m orphology. Status Post eradication was observed significantly move oft en in cases with minimal chronic inactive gastritis (43.8%) than in ca ses with reactive gastritis (7.1%, p<0.004). Furthermore, positive ELI SA and/or status after eradication was found in 50% of the cases with minimal chronic inactive gastritis (p<0.005 vs reactive gastritis), in 42.9% of the cases with mixed reactive/chronic inactive gastritis (p< 0.03 vs reactive gastritis), and in 7.1% of the cases with reactive ga stritis. Lymphoid aggregates, considered another sign of former H. pyl ori presence, were found significantly more often in minimal chronic i nactive gastritis than in reactive gastritis (50% versus 7.1%, p<0.005 ). Minimal chronic inactive gastritis is significantly associated with both positive H. pylori serology and status post eradication and is, therefore, an indicator of pre-existing H. pylori gastritis.