Abstract
Objective: To determine the prevalence of H. pylori induced gastritis and its association with development of chronic inflammation and carcinoma with reference to updated Sydney classification, to ensure the proper diagnosis and timely treatment. Methods: This was a cross sectional study conducted at the Department of Pathology, Dow Diagnostic Reference and Research Laboratory for the year 2018. Analysis of about 726 gastric biopsy specimens was performed to identify the epidemiological status of the disease. On the other hand, 100 of the specimens were analysed according to Sydney classification to ensure the accurate diagnosis of the gastritis and related disorders. Out of 726 biopsy samples positive samples for carcinoma were investigated in detail histological features. Giemsa stain was used to visualize the h pylori bacteria and the sections of biopsies were subjected to haematoxylin and eosin staining for histological analysis. Results: Out of 727 cases, H. pylori was found in 492 (67.8%) patients. About 1.79% (13) cases were identified as adenocarcinoma, 0.27% (2) squamous cell carcinoma and 0.13% (1) as B cell non Hodgkin lymphoma. Results of Sydney classification. The degree of chronic inflammatory activity was 57% mild; 38% moderate and 3% severe out of a total of 67% cases in an active phase of Hp gastritis. Hp-associated gastritis was the most common form of chronic gastritis, without intestinal metaplasia and with mild activity. The association of h pylori with mild inflammation and Neutrophilic infiltrates of the lamina propria, pits, or surface epithelium was statistically significant (p value H. pylori infection is common in our population but the infection is mild to moderate and its Sydney classification reveals that early diagnosis may prevent the later complication.
Highlights
Helicobacter pylori (H. pylori) is the main etiological agent for antral gastritis, and plays a leading pathogenic role in duodenal ulcers and majority of non-NSAID gastric ulcers
The frequency of H. pylori infection is common in our population but the infection is mild to moderate and its Sydney classification reveals that early diagnosis may pre
Invasive tests have been considered as gold standard and timely diagnosis of H. pylori infection is crucial for eradication of infection to prevent atrophic gastritis and GC which are consequences of peptic ulcer [9]
Summary
Helicobacter pylori (H. pylori) is the main etiological agent for antral gastritis, and plays a leading pathogenic role in duodenal ulcers and majority of non-NSAID gastric ulcers. There is high prevalence of H. pylori in the developing world where people have low socio-economic status and live in an unhygienic environment It is one of the most important causes or prerequisites of peptic and duodenal ulcer disease in Pakistani population [1] [2] [3]. H. pylori could be present in a significant number of dyspeptic patients with endoscopically normal stomach [7] which may cause peptic ulcer disease. It is more common in duodenal ulcer than gastric ulcer and frequency of bacterial load increases with the increasing age [8]. Objective of the current study is to audit the prevalence of H. pylori associated gastritis among Pakistani population with the severity of the disease and other associated diseases like carcinomas
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