HELICOBACTER-PYLORI AND NUCLEOLAR ORGANIZER REGIONS IN THE GASTRIC ANTRAL MUCOSA

The association of Helicobacter pylori with an increased risk of gastr ic adenocarcinoma has been documented, but its mechanisms have not bee n elucidated. This study explored these mechanisms by addressing the r elationship between H pylori and the silver-staining nucleolar organiz er regions (AgNORs) in the gastric antrum. The number of AgNORs per nu cleus has been correlated with proliferative rate and ploidy. The resu lts of gastric biopsies performed before and after treatment for H pyl ori showed that only patients who cleared the H pylori infection had a significant decrease in the number of AgNORs per nucleus. A positive association between AgNOR counts and the severity of polymorphonuclear infiltrate could be demonstrated in patients who did not clear H pylo ri infection. The authors concluded that H pylori infection alters the replication cycle of the antral mucosa, inducing hyperproliferation a nd possibly ploidy abnormalities. Whether these alterations are induce d directly by the bacterium or by the acute inflammatory infiltrate re mains undecided; the data in this study suggest a possible direct effe ct of the polymorphonuclear leukocytes.