Prevalence and associated factors of premalignant lesions in patients with helicobacter pylori infection

Abstract

Aim :

Helicobacter pylori has revolutionized our thinking on gastric carcinogenesis. However, given the low percentage of infected patients who develop gastric cancer, one may hypothized the presence of factors involving in the carcinogenesis. The aim of our study was to evaluate the prevalence of premalignant lesions: gastric atrophy and intestinal metaplasia in a population infected with Helicobacter pylori ; and to investigate about the factors predicting their development.

Methods:

This is a prospective study, including 481 patients with H.pylori infection confirmed by histological study of gastric biopsies performed per endoscopy.

Results:

Among our patients we had 216 (44, 9 %) women and 265 (55,1%) men. Chronic antral gastritis was found in 478 of patients (99,4%) and chronic fundic gastritis in 405  of patients (84,4%). The prevalence of gastric dysplasia was 0.4% . In our patients 12,6 % had gastric atrophy  and  7,7 % had intestinal metaplasia. Multivariate analysis showed that only the activity of gastritis is an independent risk factor for the premalignant lesions :  Gastric Atrophy : Antrum (OR = 2,66 ; p<0,001 ;)  , Fundus : (OR = 2,09 ; p = 0.01 ).Intestinal metaplasia : Antrum : (OR=1,82; p=0,011 ) Fundus (OR=1,8 ; p=0,02   ).

Conclusion:

The prevalence of gastric atrophy and intestinal metaplasia in patients infected with Helicobacter pylori remains low compared with other countries. The activity of gastritis is significantly associated with these premalignant lesions.

Keywords :  Helicobacter pylori . Gastritic Atrophy. Intestinal metaplasia.