Relationship between progression of gastric mucosal atrophy andHelicobacter pylori infection: Retrospective long-term endoscopic follow-up study

Abstract

A retrospective long-term endoscopic followup study was designed to examine atrophic changes in the gastric mucosa over time inHelicobacter pylori-positive patients. Over a period of 8–17 years (mean, 13.4 years) 22 subjects (5 men, 17 women, mean age, 55 years) without localized gastroduodenal lesions underwent serial endoscopic examinations and serological and microbiological assessments ofH. pylori infection. The extent of atrophic mucosa in the gastric body was expressed using the Kimura-Takemoto classification of atrophic pattern. Atrophic patterns were unchanged over time in 7H. pylori-seronegative and culture-negative subjects with normal stomach, and in 1 seropositive and culture-negative subject with severe atrophy. Seven of 10H. pylori culture-positive subjects not including three with the O-3 pattern, i.e., open type atrophic pattern, exhibited a cephalad shift of atrophic pattern. The cumulative progression rates of atrophy in the culture-positive subjects excluding O-3 subjects, were 10% after 2 years, 20% after 4 years, 50% after 6 years, and 70% after 8 years. The increases in the extent of the atrophic area were discontinuous, in terms of age, in theH. pylori-positive individuals and occasionally advanced rapidly within periods of several years with no relation to age.