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

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 less than 0.001). Acute inflammatory cell counts were significantly higher in the surface epithelium in grade 1 (P less than 0.05) and grade 2 biopsies (P less than 0.001) but chronic inflammatory cells were only higher in grade 1 (P less than 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.