Intestinal metaplasia and Helicobacter pylon: An endoscopic bioptic study of the gastric antrum

Abstract

To study the relationship between intestinal metaplasia and Helicobacter pylori infection, 2274 gastroscopic antrat biopsies taken from 533 patients were examined. Overall, intestinal metaplasia was found in 135 patients (25-3%) and H pylori in 289 patients (54-2%). The prevalence of intestinal metaplasia and H pylori was age related, being more common in patients ≥50 years compared with patients <50 years (intestinal metaplasia, p<0·001 and H pylori, p<0·05). Intestinal metaplasia was found more often in H pylori positive patients compared with H pylori negative patients (33·9% v 15·2%, p<0·001). The mean age of intestinal metaplasia positive patients who were also H pylori positive was 64 (13·3) years, whereas the mean age of intestinal metaplasia positive patients who were H pylori negative was 72 (14·7) years (p<0·005). The extent of intestinal metaplasia was not statistically different in the latter two groups. Although our data do not prove a causal relationship between H pylori infection and the histogenesis of intestinal metaplasia it is suggested that H pylori infection is an important factor in the development of intestinal metaplasia, which is generally recognised as a precursor lesion of intestinal type gastric carcinoma.