Abstract

Gastric biopsy specimens from 140 patients (66 chronic gastritis, 33 gastric ulcers, 26 duodenal ulcers, 15 gastric cancers) were examined to investigate the topographic difference of inflammation, glandular atrophy, intestinal metaplasia, and Helicobacter pylori (H. pylori) colonization by the updated Sydney system. Density of H. pylori of the antrum was significantly higher in duodenal ulcers than in chronic gastritis, gastric ulcers, and gastric cancers. Inflammation of duodenal ulcers was predominantly antral and glandular atrophy and intestinal metaplasia of duodenal ulcer were significantly less than those of gastric ulcers and gastric cancers. Chronic inflammation of gastric ulcers and gastric cancers was higher in antrum than in corpus. Increasing atrophy of the antrum was associated with decreasing density of H. pylori of antrum itself, but increasing colonization of the corpus. This study reveals the inflammatory reactions of gastric mucosa differ in chronic gastritis, gastric ulcers, gastric cancers, and duodenal ulcers and suggests that antral atrophy fosters the colonization of oxyntic mucosa by H. pylori.

• Keywords: Helicobacter pylori;Inflammation;Topographic difference