HELICOBACTER-PYLORI AND EARLY GASTRIC-CANCER

The relation between Helicobacter pylori, intestinal metaplasia, and e arly gastric cancer was studied by examining gastrectomy specimens fro m 31 intestinal type and 22 diffuse type carcinomas. A total of 298 pa tients with antral gastritis were used as controls. Atrophic changes a nd intestinal metaplasia were significantly more common in intestinal type early gastric cancer compared with diffuse type early gastric can cer (p < 0.05 and p < 0.001, respectively). H pylori was found in 61.3 % of intestinal type early gastric cancer and in 54.5% of diffuse type early gastric cancer (NS). The age adjusted prevalence of intestinal metaplasia in the patients with antral gastritis was higher in H pylor i positive patients in all age groups studied. Comparing gastritis pat ients with patients with intestinal type early gastric cancer showed t he age adjusted prevalence of intestinal metaplasia to be significantl y higher in the patients with early gastric cancer in all age groups s tudied. In conclusion, H pylori is associated with both types of early gastric carcinoma. Intestinal metaplasia formation seems to be a mult ifactorial process in which H pylori may play a part. These findings s uggest that gastric cancer may be included in the spectrum of H pylori associated diseases, although many questions about causality remain t o be answered.