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 21 February 2018

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Atrophic gastritis and intestinal metaplasia after H. pylori eradication

The latest Alimentary Pharmacology & Therapeutics investigates reversibility of atrophic gastritis and intestinal metaplasia after Helicobacter pylori eradication. 

News image

Atrophic gastritis and intestinal metaplasia are premalignant conditions for gastric cancer.

Their reversibility by Helicobacter pylori eradication remains controversial.

Dr Hwang and colleagues from South Korea evaluated the reversibility of atrophic gastritis and intestinal metaplasia by Helicobacter pylori eradication with long-term follow-up.

The researchers noted that 598 subjects were prospectively enrolled and followed for up to 10 years.

They were categorized as Helicobacter pylori-negative, Helicobacter pylori non-eradicated, and Helicobacter pylori-eradicated.

Atrophic gastritis in antrum improved only in the H.pylori-eradicated group
Alimentary Pharmacology & Therapeutics

Histological assessment was performed for antrum and corpus by Sydney classification.

Histological follow-up was performed regularly at 1, 2, 3-4 and ≥5 years, with mean follow-up of 1.07, 2.29, 3.93, and 6.45 years, respectively.

The researchers noted that atrophic gastritis in antrum and corpus gradually and significantly improved only in the Helicobacter pylori-eradicated group compared to that at baseline.

The team reported significant differences in atrophic gastritis between Helicobacter pylori-eradicated, and Helicobacter pylori-negative groups disappeared from 1-year follow-up.

Similarly, intestinal metaplasia in antrum and corpus improved significantly only in the Helicobacter pylori-eradicated group in comparison with that at baseline.

The research team not significant difference in intestinal metaplasia between Helicobacter pylori-eradicated, and Helicobacter pylori-negative groups disappeared from ≥5 years of follow-up in the antrum and from 3 years of follow-up in the corpus.

Dr Hwang's team concludes, "Helicobacter pylori eradication may be a preventative strategy for intestinal-type gastric cancer by regression of atrophic gastritis and intestinal metaplasia."

Aliment Pharmacol Ther 2018: 47(3): 380–390
23 January 2018

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