Role of aging in the expression of Helicobacter pylori gastritis in the antrum, corpus, and cardia

Background: Earlier studies identified a pylorocardial expansion of chronic gastritis. We investigated the age-dependent changes in grading and topogr aphy of Helicobacter pylori gastritis. Methods: Antral, corpus, and cardial biopsy specimens from 216 H. pylori-positive patients with no peptic ulcer disease (PUD), malignancy, or Barrett's oesophagus were evaluated with hae matoxylin and eosin and modified Giemsa. The patients were separated into f our equal-sized age groups (I, < 46 years; II, 46-56 years; III, 57-68 year s; IV, > 69 years). Sydney-system gradings of bacterial density and activit y and degree of gastritis were used to calculate gastritis sum scores for a ge- and biopsy site-dependent comparisons. The prevalence of intestinal met aplasia (IM) and atrophy was also compared. Results: Mean antral sum scores decreased slightly in group IV but were higher than those in the corpus or cardia in all groups (P < 0.05 each). In the corpus mean scores increased in groups II-IV versus group I (P < 0.05 each). and aging was associated wi th a significant increase in bacterial density and active inflammation. The cardia scores remained virtually constant in all groups and exceeded signi ficantly that in the corpus in group I. IM and atrophy increased with age, occurring more frequently and earlier in the antrum and cardia than in the corpus. Conclusion: progression of gastritis with age involves the corpus b ut nor the cardia. Antral inflammation decreases slightly in patients of ad vanced age.