Investigation of the relationship between gastric antral inflammation and campylobacter pylori using graphic tablet planimetry

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Abstract
Gastric antral endoscopic pinch biopsies from a group of dyspeptic patients were analysed for acute and chronic inflammatory cell numbers in the lamina propria and surface epithelial layer using computer‐linked graphic tablet planimetry, and independently graded for Campylobacter pylori (CP) infection using a visual scoring system with grade 1 assessed as patchy epithelial infection and grade 2 as a continuous layer of organisms on the mucosal surface extending into gastric pits. The study group consisted of 36 patients (18 duodenitis; 18 non‐ulcer dyspepsia). Within the 140 biopsies analysed, grade 1 and 2 biopsies had significantly higher acute and chronic inflammatory cell counts than CP‐negative biopsies (grade 0) in lamina and surface epithelium (P< 0·001). Acute inflammatory cell counts were significantly higher in the surface epithelium in grade 1 (P<0·05) and grade 2 biopsies (P<0·001) but chronic inflammatory cells were only higher in grade 1 (P<0·01). No significant differences were present between grade 1 and grade 2 biopsies for any parameter. This study confirms that highly significant quantitative differences in the inflammatory status are related to the presence of CP.