GASTRIC-CARCINOMA RISK INDEX IN PATIENTS INFECTED WITH HELICOBACTER-PYLORI

Epidemiological data show an association between Helicobacter pylori g astritis and gastric carcinoma. However, most people infected with H. pylori do not develop gastric cancer. We have therefore evaluated hist ological criteria indicating an increased risk for gastric cancer. H. pylori gastritis was investigated in 117 patients with small (O<2 cm) early gastric carcinomas and in 117 age-matched duodenal ulcer patient s infected with H. pylori, who are known to have a low risk for develo ping gastric carcinoma, The results showed that infiltration with lymp hocytes/plasma cells and infiltration with neutrophils predominating i n the corpus, and intestinal metaplasia in antrum and corpus were asso ciated with both types of gastric carcinoma (intestinal and diffuse, P <0.0001). If an index is computed by giving one point to each of these features, the predictive value for the presence of gastric carcinoma was 0.79 with a score of 2, and 0.94 with a score of 3 (all points on the index used). Application of this index might be a simple method of identifying patients infected with H. pylori and carrying a higher ri sk for gastric carcinoma.