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A five-year follow-up study on the pathological changes of gastric mucosa after H. pylori eradication.
Chin Med J (Engl). 2003 Jan; 116(1):11-4.CM

Abstract

OBJECTIVES

To investigate the relationship between H. pylori infection, gastric cancer and other gastric diseases through the changes in gastric mucosa and the status of different gastric diseases within 5 years after H. pylori eradication in H. pylori-positive subjects in a high incidence region of gastric cancer.

METHODS

One thousand and six adults were selected from the general population in Yantai, Shandong province, a high incidence region for gastric cancer in China. Gastroscopy and Campylobacter-like organism (CLO) testing were performed on all subjects. Biopsy samples from the gastric antrum and body were obtained for histology and assessment of H. pylori infection. All H. pylori-positive subjects were then randomly divided into two groups: treatment group receiving Omeprazole Amoxicillin Clarythromycin (OAC) triple therapy and placebo as controls. These subjects were endoscopically followed up in the second and fifth year. We compared the endoscopic appearance and histology of the biopsy specimens from the same site obtained at the first and last visits.

RESULTS

All 552 H. pylori-positive subjects were randomly and evenly divided into treatment group or control group. During the five-year follow-up, the numbers of patients who continued to be negative or positive for H. pylori were 161 and 198, respectively. Statistical analysis revealed that: (1) At the initial visit, there were no significant differences in the severity and activity of inflammation, atrophy and intestinal metaplasia between the biopsy specimens from the antrum and body respectively in both groups. (2) The severity and activity of inflammation in both the antrum and body were markedly reduced after H. pylori eradication (P = 0.000). (3) Within five years after H. pylori eradication, intestinal metaplasia in the antrum either regressed or had no progression, while the proportion of intestinal metaplasia in the H. pylori-positive group increased significantly (P = 0.032). (4) After H. pylori eradication, the atrophy in both the antrum and body had no significant regression. The P value was 0.223 and 0.402, respectively.

CONCLUSIONS

H. pylori eradication results in remarkable reduction in the severity and activity of chronic gastritis, marked resolution of intestinal metaplasia in the antrum. On the other hand, continuous H. pylori infection leads to progressive aggravation of atrophy and intestinal metaplasia.

Authors+Show Affiliations

Department of Gastroenterology, The Third Hospital of Peking University, Beijing 100083, China. zly__zhou@yahoo.com.cnNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

12667379

Citation

Zhou, Liya, et al. "A Five-year Follow-up Study On the Pathological Changes of Gastric Mucosa After H. Pylori Eradication." Chinese Medical Journal, vol. 116, no. 1, 2003, pp. 11-4.
Zhou L, Sung JJ, Lin S, et al. A five-year follow-up study on the pathological changes of gastric mucosa after H. pylori eradication. Chin Med J (Engl). 2003;116(1):11-4.
Zhou, L., Sung, J. J., Lin, S., Jin, Z., Ding, S., Huang, X., Xia, Z., Guo, H., Liu, J., & Chao, W. (2003). A five-year follow-up study on the pathological changes of gastric mucosa after H. pylori eradication. Chinese Medical Journal, 116(1), 11-4.
Zhou L, et al. A Five-year Follow-up Study On the Pathological Changes of Gastric Mucosa After H. Pylori Eradication. Chin Med J (Engl). 2003;116(1):11-4. PubMed PMID: 12667379.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A five-year follow-up study on the pathological changes of gastric mucosa after H. pylori eradication. AU - Zhou,Liya, AU - Sung,Joseph J Y, AU - Lin,Sanren, AU - Jin,Zhu, AU - Ding,Shigang, AU - Huang,Xuebiao, AU - Xia,Zhiwei, AU - Guo,Huilan, AU - Liu,Jianjun, AU - Chao,William, PY - 2003/4/2/pubmed PY - 2003/4/16/medline PY - 2003/4/2/entrez SP - 11 EP - 4 JF - Chinese medical journal JO - Chin Med J (Engl) VL - 116 IS - 1 N2 - OBJECTIVES: To investigate the relationship between H. pylori infection, gastric cancer and other gastric diseases through the changes in gastric mucosa and the status of different gastric diseases within 5 years after H. pylori eradication in H. pylori-positive subjects in a high incidence region of gastric cancer. METHODS: One thousand and six adults were selected from the general population in Yantai, Shandong province, a high incidence region for gastric cancer in China. Gastroscopy and Campylobacter-like organism (CLO) testing were performed on all subjects. Biopsy samples from the gastric antrum and body were obtained for histology and assessment of H. pylori infection. All H. pylori-positive subjects were then randomly divided into two groups: treatment group receiving Omeprazole Amoxicillin Clarythromycin (OAC) triple therapy and placebo as controls. These subjects were endoscopically followed up in the second and fifth year. We compared the endoscopic appearance and histology of the biopsy specimens from the same site obtained at the first and last visits. RESULTS: All 552 H. pylori-positive subjects were randomly and evenly divided into treatment group or control group. During the five-year follow-up, the numbers of patients who continued to be negative or positive for H. pylori were 161 and 198, respectively. Statistical analysis revealed that: (1) At the initial visit, there were no significant differences in the severity and activity of inflammation, atrophy and intestinal metaplasia between the biopsy specimens from the antrum and body respectively in both groups. (2) The severity and activity of inflammation in both the antrum and body were markedly reduced after H. pylori eradication (P = 0.000). (3) Within five years after H. pylori eradication, intestinal metaplasia in the antrum either regressed or had no progression, while the proportion of intestinal metaplasia in the H. pylori-positive group increased significantly (P = 0.032). (4) After H. pylori eradication, the atrophy in both the antrum and body had no significant regression. The P value was 0.223 and 0.402, respectively. CONCLUSIONS: H. pylori eradication results in remarkable reduction in the severity and activity of chronic gastritis, marked resolution of intestinal metaplasia in the antrum. On the other hand, continuous H. pylori infection leads to progressive aggravation of atrophy and intestinal metaplasia. SN - 0366-6999 UR - https://www.unboundmedicine.com/medline/citation/12667379/A_five_year_follow_up_study_on_the_pathological_changes_of_gastric_mucosa_after_H__pylori_eradication_ DB - PRIME DP - Unbound Medicine ER -