LONG-TERM SEMIQUANTITATIVE FOLLOW-UP OF HELICOBACTER-PYLORI-ASSOCIATED GASTRITIS

Helicobacter pylori infection has been implicated with the development of gastric carcinoma and lymphoma. We studied the long-term effects o f H. pylori infection on gastric mucosa. Ten patients with Helicobacte r pylori infection underwent repeat endoscopy and antral biopsies 8 ye ars later. Gastric mucosal features (polymorphs, monocytes, intestinal metaplasia, atrophy and lymphoid aggregates) were graded from mild to severe (0 to 3) based on the Sydney system of gastritis classificatio n. At repeat biopsy, 1 patient was negative for H. pylori after eradic ation therapy. Two patients (20 per cent) had spontaneous disappearanc e of H. pylori. One of these had intestinal metaplasia which progresse d to low grade dysplasia. Polymorphs decreased with eradication of H. pylori (P<0.05). Lymphoid aggregates increased with continued H. pylor i infection but decreased with eradication of H. pylori (P<0.05). Mono cytes, intestinal metaplasia and atrophy remained unchanged. Persisten t H. pylori infection appears to increase lymphoid aggregates and may promote its evolution into gastric lymphoma while eradication of H. py lori may result in a reduction of polymorphs and lymphoid aggregates.