MICROFLORA OF GASTRIC BIOPSIES FROM PATIENTS WITH DUODENAL-ULCER AND GASTRIC-CANCER - A COMPARATIVE-STUDY OF PATIENTS FROM KOREA, COLOMBIA,AND THE UNITED-STATES
Ms. Osato et al., MICROFLORA OF GASTRIC BIOPSIES FROM PATIENTS WITH DUODENAL-ULCER AND GASTRIC-CANCER - A COMPARATIVE-STUDY OF PATIENTS FROM KOREA, COLOMBIA,AND THE UNITED-STATES, Digestive diseases and sciences, 43(10), 1998, pp. 2291-2295
It remains unclear why the spectrum of H, pylori-related diseases diff
ers among different geographic regions. We examined the non-H, pylori
contamination rates of the stomach in patients with duodenal ulcer or
gastric adenocarcinoma from three different regions with different spe
ctra of H. pylori-related diseases. Gastric biopsies were cultured fro
m patients with duodenal ulcer or histologically proven gastric cancer
from Seoul, Korea; Bogota, Colombia; and Houston, Texas. The frequenc
y of non-H. pylori contamination was tallied in relation to the clinic
al diagnosis. Cultures from 247 duodenal ulcer patients and 165 patien
ts with gastric cancer had bacterial growth. H. pylori was isolated fr
om 207 (73.7%) patients with duodenal ulcer and 90 (47.1%) patients wi
th gastric cancer (P < 0.001), In patients with duodenal ulcer (DU) or
gastric cancer (GC), the rate of positive cultures for H, pylori were
not statistically different (P > 0.143 for DU, P > 0.190 for GC) betw
een regions. The frequency of isolation ranged from 69% to 79% for DU
patients and from 39% to 50% for gastric cancer patients. Non-H, pylor
i bacterial contamination was found more frequently (63%) in Colombian
duodenal ulcer patients compared to 30% ulcer patients from the Unite
d States or Korea (P < 0.001). Non-H. pylori growth occurred in 50.8-7
5.5% of cancer patients and was significantly lower in US patients tha
n in patients from either Colombia or Korea (P < 0.01). The geographic
location as well as disease status affects the rate of H, pylori reco
very and non-H. pylori contamination of the stomach and may play a rol
e in the geographic differences in manifestation of H. pylori infectio
n. The fact that the proportion of gastric cancer patients in the Unit
ed States with non-H, pylori contamination was significantly less than
that of Korea or Colombia shows that the notion of an almost universa
l increase in gastric microbial content in gastric adenocarcinoma shou
ld be reconsidered.