HELICOBACTER PYLORI AND GASTRIC CANCER: IS THERE A LINK?

This paper examines the correlation between prevalence of H pylori, gastritis and the histological type of gastric cancer. 50 gastrectomy specimens from the patients with gastric cancers were studied for the prevalence of H pylori, type of gastritis as classified by the Sydney system, presence of intestinal metaplasia, and the histological type of gastric cancer. H pylori was detected in 27 (54%) stomachs. The common site for finding this bacterium was either antrum or body of stomach (16 and 17 sections respectively), Gastritis was found in 48/50 specimen (96%) from non-neoplastic areas. However, 15 of the 18 patients with atrophic gastritis had H pylori in their stomach specimens either in the body or in antrum. Intestinal metaplasia was detected in 19 (38%) specimen. Of these, 14 (73.7%) specimens had type 1 and remaining 5 (26.3%) had type 2 metaplasia. The distribution of metaplasia was significantly more in H pylori positive patients. Prevalence of H pylori positivity was highest in intestinal type of cancer (66.7%) and lowest in diffuse variety (45.8%). In two third specimens of intestinal type of cancer, gastritis was related to H pylori while such association with H pylori was seen in approximately half (45.8% & 57.1% respectively) the specimens of other types of cancers. There is strong association between the prevalence of H pylori and gastritis on one hand and the intestinal metaplasia on the other, in patients with gastric cancer. These findings, indirectly support Correa's hypothesis that H pylori is a causal factor in the intestinal form of gastric cancer.