Sustained increase in gastric antral epithelial cell proliferation despitecure of Helicobacter pylori infection

OBJECTIVE: Studies of the effect of Helicobacter pylori treatment on gastri c mucosa proliferation have yielded inconsistent results. We compared gastr ic mucosa cell proliferation posttherapy and in uninfected controls. METHODS: Biopsies were obtained from patients with H. pylori infection befo re treatment and at intervals for up to 33 months. Epithelial cell prolifer ation was determined using Ki-67 immunostaining. The labeling index (LI) is the proportion of positively labeled cells with respect to the total numbe r of cells. The proliferative index was calculated by multiplying the label ing index (LI) and the proliferation zone PZ (PZ = length of the area betwe en the uppermost and lowest labeled cells). RESULTS: The study included 27 patients with H. pylori gastritis and 35 con trols. Epithelial cell proliferation (LI) was greater with H. pylori infect ion than without in both the antrum and corpus (65 +/- 5 vs 91 +/- 8 in the antrum and 44 +/- 3 vs 72 +/- 8 in the corpus, for uninfected controls vs H. pylori gastritis, respectively) (p = 0.0001). In the antrum there was no significant decrease in epithelial cell proliferation after cure of the H. pylori infection despite follow-up for >2 yr (labeling index = 83 +/- 10). In contrast, epithelial cell proliferation decreased in the corpus and bec ame similar to that in controls after 7-13 months. CONCLUSIONS: Patients with H, pylori infection have sustained high epitheli al cell proliferation in the antrum compared to that in uninfected subjects . A continued increase in proliferation in the antrum after cure of H. pylo ri infection suggests continuing damage. (C) 2000 by Am. Cell. of Gastroent erology.