Long-term effects of Helicobacter pylori eradication on gastric antral mucosa in duodenal ulcer patients

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Abstract
The aim of this study was to assess the consequences of prolongedHelicobacter pylorieradication on gastric antral mucosa in duodenal ulcer patients. Forty-three duodenal ulcer patients with confirmedH. pylorieradication after one year of follow-up were included in this retrospective study. BeforeH. pylorieradication and during the follow-up, four antral prepyloric biopsy samples were taken for histopathological examination and culture. Histopathological lesions were graded semi-quantitatively according to the updated Sydney System for activity, chronic inflammation, glandular atrophy and intestinal metaplasia (IM), as well as presence of lymphoid follicles. After a mean follow-up of 43 ± 23 months,H. pylorieradication statistically improved all gastritis scores, including the atrophy score and the lymphoid follicle score but excluding the IM score.H. pylorieradication resulted in normalization of gastric mucosa in 51.2% of patients and a significantly lower proportion of patients with non-atrophic gastritis and atrophic gastritis without IM. Atrophy totally disappeared in 16/29 patients (55.2%) in whom IM was absent. No predictive factor for regression of atrophy or normalization of gastric mucosa was identified. In duodenal ulcer patients, prolonged absence (more than one year) ofH. pylorican lead to normalization of the antral mucosa and the disappearance of mucosaassociated lymphoid tissue, as well as the regression of antral atrophy. Long-term studies involving selected patients with atrophy and IM which persist afterH. pylorieradication are needed to determine the potential benefits of treatingH. pylorigastritis with regard to gastric cancer prevention.Eur J Gastroenterol Hepatol12:719-725

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