H.Pylori Associated Gastritis

摘要

Introduction: H.Pylori has been associated with various upper gastro-intestinal tract disorders including gastritis, peptic ulcer and gastric malignances. There is a paucity of literature regarding the study of morphological changes in H.Pylori associated gastritis, as H.Pylori colonized gastric mucosa is a distinct pathologic entity with a pathologic spectrum ranging from active chronic gastritis to erosions frank ulcer. Objective: The aim of this study was to know the morphological changes seen in gastric mucosa associated with H.Pylori. And also to find out prevalence of H.Pylori in patients undergoing upper gastro-intestinal endoscopic biopsies with gastritis in the centre. Materials and Methods: A total of 100 patients who were clinically diagnosed as having acute or chronic gastritis were included for this study during the period December 1999 to December 2001. A detailed clinical history was taken as per the standard proforma. Then the patients were subjected for endoscopy. Five endoscopic biopsies were taken and processed for rapid urease test and histopathological examination. Results: Out of 100 cases of endoscopically diagnosed gastritis, 48 cases were H.Pylori positive. In this 48 H.Pylori positive cases, 43 were positive by both rapid urease test (RUT) and histopathology. 3 cases were RUT positive but negative for H pylori by histopathology, and 5 cases were negative by RUT but histopathology showed presence of H.Pylori. Morphological changes specific for H.Pylori colonization and characteristic features are irregular surface epithelium, loss of apical mucin, cell dropout, formation of pits and microerosions. Out of 100 cases, 46 were RUT positive and 54 cases RUT negative. 48 were histology positive and 52 were histology negative. Statastically, no significant difference between urease test and histopathological demonstration of H.Pylori (p>0.05). Conclusions: Prevalence of H.Pylori in the present study was 48 in patients undergoing upper gastro-intestinal endoscopic biopsies with gastritis in this centre. H.Pylori infection is associated with spectrum of histological changes in gastric mucosa, which in turn facilitates the identification of H.Pylori. RUT and histopathology are the 2 diagnostic methods which can be used with an equal importance for the detection of H.Pylori associated lesions.