TITLE:
Gastric Atrophy, Intestinal Metaplasia in Helicobacter pylori Gastritis: Prevalence and Predictors Factors
AUTHORS:
S. Adadi, B. Bennani, M. Elabkari, A. Ibrahimi, S. Alaoui, M. Elkhadir, T. Harmouch, M. Mahmoud, C. Nejjari, D. Benajah
KEYWORDS:
Gastric Atrophy, Intestinal Metaplasia, Helicobacter pylori, Gastritis
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.4 No.10,
October
19,
2016
ABSTRACT: Gastric
atrophy and intestinal metaplasia represent the most important premalignant
lesions in gastric carcinogenesis. The severity of gastric mucosal inflammation
depends on the bacterium Helicobacter
pylori (HP), on the host and on
environmental factors. The aim of our study is to determine the prevalence and
factors associated with Gastric atrophy and intestinal metaplasia in patients
infected with Helicobacter pylori. Methods: This is a prospective study over a period of 4 years (May 2009 - January 2015)
conducted in the service of Hepatology and Gastroenterology in hospital university
Hassan II of Fez in collaboration with microbiology and molecular biology laboratory
and epidemiology service of Faculty of Medicine and Pharmacy Fes. We included
in our study all patients aged over 15 years, having ulcerative dyspepsia,
peptic ulcer disease, gastritis or esophagitis. Results: During the
study period, 1190 patients were included of which 70% had HP infection (N = 833).
The average age was 48.21 years [16 - 99
years], sex ratio M/F was
1, 11. 60% of patients were older than 45 years. Chronic smoking was found in
12% of patients. Gastric atrophy was observed in 84% (N = 699) of patients infected with HP. Gastric atrophy
was localized in 70% in the antrum and 30% in the fundus and 24% in both. The
activity of gastritis (p = 0.0001) and the density of the HP (p = 0.005) were
factors associated with atrophy. Intestinal metaplasia was observed in 13.5% of
patients (N = 112). The density of HP (p = 0.037) and severe atrophy (p =
0.001) were factors associated with metaplasia. Other factors studied: age,
sex, smoking, CagA+ genotype were not associated with either
gastric atrophy or intestinal metaplasia. Conclusion: In our study, the
prevalence of atrophic gastritis and intestinal metaplasia in patients infected
with Helicobacter pylori was 84% and
13.5% respectively, which was a high
prevalence. The activity of gastritis, and density of HP were factors
associated with atrophy. The density of HP and severe atrophy were factors
associated with metaplasia.