THE LONG-TERM EFFECT OF HELICOBACTER-PYLORI ON GASTRIC-MUCOSA

Objective: To investigate the sequence of histological change over a p rolonged period of time in patients with an initial diagnosis of Helic obacter pylori-positive gastritis. Methods: Endoscopy reports and hist ology specimens from 182 patients, with an initial diagnosis of chroni c active gastritis and whose biopsy was repeated after a 3-month inter val, were included in the study. All biopsies were reviewed for the pr esence or absence of H. pylori. Results: The time interval between gas troscopic examination ranged from 3 months to 4 years (mean 6 months). Of the 182 patients, 170 (93%) were H. pylori-positive. Of the 160 bi opsies which were repeated at an interval of less than 2 years, all sh owed the original features of chronic active gastritis or had reverted to normal. Of the 22 biopsies which were repeated at an interval of m ore than 2 years, 12 (54%) showed evidence of progression to chronic a trophic gastritis, while one patient (4.5%) showed evidence of dysplas ia. All of these patients had histological confirmation of H. pylori i nfection on initial biopsy. Conclusion: These results support the theo ry that there is a progression from normal mucosa to carcinoma, which takes place over a number of years.