A study on the epithelial proliferation in Helicobacter pylori associated gastric premalignant and malignant lesions / 대한내과학회지

ABSTRACT

BACKGROUND: Many studies have demonstrated that increased cell proliferation in gastric epithelium is associated with Helicobacter pylori (H. pylori) infection. Increased epithelial proliferation is one of the earliest mucosal changes observed in gastric carcinogenesis. The aim of this study was to evaluate the influence of H. pylori infection for epithelial proliferation at different stages of gastric carcinogenesis from chronic gastritis to adenocarcinoma. METHODS: Gastric biopsy specimens were collected from 129 patients who underwent esophagogastroduodenoscopy with biopsy. Histologically, there were 29 patients with chronic gastritis, 26 chronic gastritis with intestinal metaplasia, 31 low grade dysplasia, 18 high grade dysplasia, and 25 gastric adenocarcinoma. Status of H. pylori infection was determined by rapid urease test, modified Giemsa stain and 13C-urea breath test. Epithelial cell proliferation was assessed by immunohistochemical method using anti-PCNA antibody. RESULTS: The grade of epithelial proliferation was higher in H. pylori infected patients than uninfected patients (p=0.007) and progressively increased at different stages from chronic gastritis to gastric adenocarcinoma (p<0.001). The analysis of epithelial proliferation according to H. pylori infection status in each histologic group showed that the grades of epithelial proliferation were higher in H. pylori infected patients than uninfected patients in all groups except adenocarcinoma group. CONCLUSION: H. pylori infection causes increased gastric epithelial cell proliferation and may play an important role in gastric carcinogenesis.