HISTOLOGICAL PROFILE OF HELICOBACTER PYLORI-INDUCED CHRONIC GASTRITIS: ABOUT 227 CASES

Aims:

The aim of our work is to define the different histological aspects of gastritis associated with HP infection.

Methods:

A retrospective study was performed, collating 227 patients admitted to our unit between August 2016 and November 2016 for upper endoscopy. Inclusion criterion was presence of chronic HP gastritis on the histological examination. Gastritis in the vicinity of malignant neoplasia or peptic ulcer were excluded.

Results:

Average age of patients was 47.2 years (extremes ranging from 14 to 85 years) with a sex ratio M/F of 0.8. The inflammation rate was light in 19.8% of the cases, moderate in 75.8% of the cases, and severe in 4.4% of the cases. The gastritis was not active in 18.5% of the cases, light in 37.0% of the cases, moderate in 36.6% of the cases, and severe in 7.9% of the cases. Density of colonization was HP+ in 40.1% of the cases, HP++ in 42.3% of the cases, and HP+++ in 17.6% of the cases.

Gastritis was atrophic in 29.5% of the cases. The atrophy was light in 68.7% of the cases, moderate in 28.3% of the cases, and severe in 3.0% of the cases. The prevalence of follicular gastritis was 15.0%. Intestinal metaplasia was found in 7.9% of the cases. In 6.6% of the patients, intestinal metaplasia was associated with gastric atrophy.

In univariate analysis, age, inflammation intensity, gastritis activity, and HP colonization density were associated with gastric atrophy (p = 0.001, p = 0.030, p = 0.044, and p = 0.016, respectively). In multivariate analysis, only age was associated with gastric atrophy (p = 0.002).

Conclusions:

In our study, gastric atrophy was present in almost 1/3 of the cases and was associated with older age. Follicular gastritis and intestinal metaplasia were infrequent.