The effect of age and Helicobacter pylori infection on gastric epithelial cell kinetics.

摘要

BACKGROUND: Helicobacter pylori infection is a known risk factor for gastric cancer. The aim of the study was to determine the effect of H. pylori and age on gastric epithelial cell kinetics. METHODS: One hundred and fifty-seven patients (92 men, median age: 58.5 years, range: 18-85) who had undergone upper gastrointestinal endoscopy due to dyspeptic symptoms were enrolled into the study. Six antral biopsy samples were obtained for flow cytometric DNA analysis (expressed as proliferative index [PI], S+G2/M phase), presence of H. pylori (CLO-test, culture and histology), and histopathologic examination. RESULTS: Eighty-four (53.5%) patients were H. pylori positive and 93.3% of patients had diploid pattern and 6.7% expressed aneuploid pattern. The mean PI was 4.8 +/- 0.2 for the whole group studied. PI were 5.14 +/- 0.33 and 4.26 +/- 0.36 for H. pylori (+) and H. pylori (-) patients respectively (P = 0.017). When age groups were taken into account, PI was found higher in patients over 75 years of age (n = 14, PI = 6.66 +/- 1.3) compared to patients under 35 years of age (n = 25, PI = 3.83 +/- 0.41, P = 0.014). There was no correlation between histological changes and PI. H. pylori (P = 0.045) and age (P = 0.082) were independent factors for PI. CONCLUSION: PI of gastric antral mucosa increases in patients with H. pylori infection. Although PI increases by age, H. pylori is the only factor that significantly and independently influences the rate of epithelial cell proliferation.