IMPLICATIONS OF HELICOBACTER-PYLORI SEROLOGICAL TITER FOR THE HISTOLOGICAL SEVERITY OF ANTRAL GASTRITIS

Background and Study Aims: We attempted to determine whether the serol ogical titer of anti-Helicobacter pylori CHP) immunoglobulin (IgG) wou ld be capable of predicting the presence of ulcer, or would correlate with the histological grading of gastritis in patients with dyspepsia. Patients and Methods: One hundred eighty-three dyspeptic patients wer e prospectively included in the study after panendoscopy. Each patient underwent blood sampling for anti-HP IgG titer, and antral biopsy for both a rapid urease test (CLO) and histology. The severity of antral gastritis was semi-quantitated for acute and chronic inflammation scor es (range 0-3). Results: The HP findings were positive in 157 patients (85.5%), and their histological inflammation scores and serological t iter were higher than those of HP-negative patients (P<0.05). Based on the endoscopic findings, these 157 patients were classified into ulce r (n=109) and non-ulcer dyspepsia (n=48) subgroups. The mean chronic i nflammation score in the ulcer subgroup was higher than that in the no n-ulcer dyspepsia subgroup (1.77 vs. 1.28, P<0.001). However, on the b asis of only the titer itself, there was no cut-off value for serologi cal titer to predict the presence or absence of ulcer in HP-infected p atients. As the scores for either acute or chronic inflammation increa sed, the mean serological titer rose (acute inflammation score 0-3: 0. 63, 0.78, 0.93, 1.39; chronic inflammation score 0-3: 0.18, 0.56, 0.88 , 0.91). Conclusions: The titer of HP serology does not provide a meth od for predicting the presence of ulcer in patients with HP infection, but may indirectly offer evidence of the severity of histological cha nges.