HELICOBACTER-PYLORI, ATROPHIC FUNDAL GASTRITIS AND RISK FOR GASTRIC ADENOCARCINOMA

Fundal atrophic gastritis and Helicobacter pylori have been implicated as possible etiologic factors in gastric cancer. This case-control st udy was performed to determine which risk factor is more closely relat ed to gastric cancer. The endoscopic Congo red test was performed to e valuate the extent of fundal atrophic gastritis in 43 patients with ga stric cancer and 86 cancer-free control subjects, who were individuall y matched by age, sex, and date of endoscopy (within 3 months). The pr evalance of H. pylori infection and severe fundal gastritis were signi ficantly higher in patients with differentiated adenocarcinoma, but no t with undifferentiated adenocarcinoma, than in control subjects. The odds ratios for differentiated and undifferentiated adenocarcinomas we re 6.85 (95% confidence interval, 1.94-11.82) and 1.50 (95% CI, 0.84-3 .11), respectively. However, the odds ratio of H. pylori infection was greater than that of severe fundal gastritis. Moreover, multivariate analysis provided similar results. H. pylori infection is an independe nt indicator of a higher risk of the differentiated adenocarcinomas of the stomach than is severe fundal gastritis.