Prevalence of H.pylori Infection and Precancerous Gastric Lesion in Family Relative of Gastric Cancer in South West of Iran

Abstract

AIM: Progression of Helicobacter Pylori-associated gastritis is a major pathway for development of gastric adenocarcinoma. A family history of gastric adenocarcinoma has been demonstrated in some studies. The aim of this study was to assess the prevalence of precancerous gastric lesions in first-degree relative of gastric adenocarcinoma patients. METHODS: After gastric adenocarcinoma was histologically confirmed in a patient, the first-degree relatives were invited to participate in the study and underwent gastric endoscopy and biopsy. The control group was comprised of individuals who underwent endoscopic retrograde cholangiopancreatography (ERCP), in whom there were no evidence of peptic ulcer and no family history of gastric adenocarcinoma. A total of six gastric biopsies were taken and studied: two from the antrum, two from corpus, and two from cardia. Histologic examinations were performed separately by three board-certified pathologists and reported according to the updated Sydney system. RESULTS: 184 individuals were included in the study, including 92 in the study group and 92 in the control group. The mean age was similar between two groups (40.75±9.5 and 40.39±11 years of age, respectively). 57.6% of the control group and 52.4% in the study group were above the age of 40. Study group showed a higher prevalence of H. pylori (HP) infection in the body and cardia, comparing to the control group (73.9% and 75% vs 58.7% and 57.8%; P=0.01 and 0.04). There was no statistically significant difference in the prevalence of antral HP infection between the two groups (70.7% vs. 58.7%; P=0.06). HP density showed similar difference between the two groups (P=0.01, P=0.04 vs P=0.06). There is significant difference between two groups in Severity of the neutrophilic infiltration in antrum, body and cardia. (P=0.004, P=0.001, P=0.01 respectively). Severity of lymphoid aggregate in the study group was greater in the antrum than of the body and cardia. (P=0.0001 vs P=0.22 and P=0.75). Study group showed higher prevalence of HP-associated chronic gastritis in antrum, body and cardia (48.9%, 44% and 38% vs 30.4%, 23.9%, 22.8%; P=0). Frequency of antral, body and cardia HP infection in the background of intestinal metaplasia (IM) was similar in the two groups (7%, 4%, 4% vs 9%, 3% and 9%; P=0.74, P=0.99, P=0.46). Prevalence of HP-associated dysplasia between study and control groups in the antrum, body, and cardia, were respectively (15%, 16%, 12% vs 13%, 5%, 18% P=0.78, P=0.07, P=0.91). CONCLUSION: Screening for HP infection and precancerous lesions may provide a preventive way for development of gastric adenocarcinoma