Extent, topography, and symptoms of Helicobacter pylori gastritis

Helicobacter pylori gastritis, a very common condition, may lead to serious sequelae such as peptic ulcer,gastric carcinoma, and mucosa-associated lym phoid tissue lymphoma. Histological grading of the various gastritis parame ters can help to identify the risk of these sequelae and thus improve the i ndication for prophylactic treatment of the H.pylori infection. This applie s in particular to two types of "risk gastritis": gastritis of the duodenal ulcer phenotype and gastritis of the carcinoma phenotype. In the former th e antrum shows pronounced inflammatory changes while only low-grade gastrit is is seen in the corpus. In the latter, by contrast, the gastritis in the corpus is at least equally as severe as that in the antrum; in addition, in testinal metaplasia and focal atrophy is also frequently found in this phen otype. By establishing topographic grading of the gastritis in antrum and c orpus the pathologist can therefore play the role of a "litmus test" for pr ophylactic H. pylori eradication treatment.