Histological Patterns in Gastric Biopsies and their Association with Helicobacter Pylori Infection

Abstract

Background: Helicobacter Pylori (H. Pylori) is recognized as the primary cause of chronic
gastritis and gastric diseases. H. Pylori is associated with increased risk of gastric cancer through
the development of a multi-step carcinogenesis. Multiple biopsies of gastric mucosa are helpful in
making a categorical diagnosis of H. Pylori induced gastric lesions.
Objective: The purpose of the study was to evaluate the morphology of different gastric lesions
associated with H. Pylori.
Material and Methods: It was a descriptive study conducted in the Department of
histopathology, Services Institute of Medical Sciences / Services Hospital, Lahore. The study
included 157 endoscopic biopsies from patients undergoing endoscopy for non-ulcer dyspepsia
during a period of one year from January 2008 to December 2008.
Results: A total of 157 gastric biopsies from patients of ages ranging from 5 to 85 years were
included, out of which 6 (3.8%) were normal. Out of 151 remaining patients, 128 (84.8%) were in
the fifth and sixth decade who were found to have chronic gastritis with evidence of H. Pylori in 42
(32.8%). 13 (8.6%) had gastric adenocarcinoma with evidence of H. Pylori in 1(7.7%). 77
(60.16%) of the patients with chronic gastritis were males out of which 26 (34%) were positive for
H. Pylori. No evidence of atrophic gastritis or intestinal metaplasia was seen.
Conclusion: Chronic gastritis was predominant diagnosis followed by gastric adenocarcinoma.
Multiple endoscopic gastric biopsies should be taken to rule out the possibility of pangastritis,
atrophic gastritis and intestinal metaplasia which are part of multi-step development of gastric
carcinoma.