Sulphomucins favour adhesion of Helicobacter pylori to metaplastic gastricmucosa

Aims-To assess the influence of sulphomucin secretion on Helicobacter pylor i colonisation and adhesion to metaplastic gastric cells. Methods-Gastric biopsies from 230 H pylori positive patients with intestina l metaplasia were analysed. Sulphated mucins and H pylori were visualised u sing a new technique combining high iron diamine-alcian blue mucin stains w ith the Steiner silver stain for the bacteria. Results-Sulpho mucin secretion anywhere in the mucosa and a histological di agnosis of dysplasia increase the risk of H pylori adhesion to metaplastic cells (odds ratios 19.9 and 4.3, respectively). However, only 9.4% of cases showing sulphomucin secretion and 10.8% of cases with dysplasia had eviden ce of adhesion of H pylori bacteria to metaplastic cells. Conclusions-The findings suggest that H pylori may play a role in the advan ced stages of carcinogenesis. It will be of interest to investigate if the relative small proportion of type III metaplasias that actually progress to carcinoma show persistence of H pylori.