Cell proliferation in the post-surgical stomach, dietary salt, and the effect of H pylori eradication

Aims-To study the epithelial kinetics of the post-surgical stomach with ref erence to dietary salt intake and H pylori. Methods-Endoscopic biopsies of the antrum/anastomosis and corpus were taken for histology and MIB-1 immunostaining. The labelling index (LI%) was dete rmined in the three zones of the gastric glands (zone 1 = surface + gastric pit; zone 2 = isthmus; zone 3 = gland base) in patients with vagotomy and pyloroplasty (n = 12), gastroenterostomy + vagotomy (n = 4), partial gastre ctomy (n = 3), and Billroth I operation (n = 3). Dietary salt was determine d by urinary sodium/creatinine ratio. Twelve patients were H pylori positiv e (10 vagotomy and pyloroplasty; 2 pai tial gastrectomy) and had a repeat b iopsy three months after antihelicobacter treatment (10 were H gylori negat ive after treatment). Results-There was no correlation between salt intake and antrum/anastomosis (r = -0.34; p = 0.2) or corpus (r = -0.16; p = 0.2) labelling indices. Gas tric mucosal proliferation is increased in the antrum/ anastomosis compared to the corpus in H pylori positive (p = 0.014) but not H pyrori negative s ubjects (p = 0.084). This may reflect the different types of post-surgical stomach in each group. Gastric mucosal proliferation is reduced in antrum/a nastomosis (p = 0.002) and corpus (p = 0.016) following H pylori eradicatio n. Conclusions-Dietary salt does not influence gastric mucosal proliferation i n the post-surgical stomach but H pylori may have a role in gastric stump c arcinogenesis.