The Effect of Helicobacter Pylori Eradication On Atrophic Gastritis and Intestinal Metaplasia in the Patients After Endoscopic Resection of Early Gastric Cancer in Korea: A 3-Year Follow-Up Study

Abstract

Background/Aims: The incidence of gastric cancer in Korea is significantly higher than that in the Western countries. The intestinal-type gastric cancer patients with H. pylori infection have severer atrophic gastritis and intestinal metaplasia (IM) compared with the controls with H. pylori infection. We performed this study to investigate the long-term effect of H. pylori eradication on atrophic gastritis and IM in the patients with early gastric cancer after EMR. Methods: The twenty one patients, who had successful H. pylori eradication and EMR, were followed up during the 36 months. Endoscopic follow-up was performed at least every 12 months after EMR. Each patient underwent a 13C-UBT or rapid urease test to determine his or her H. pylori status with endoscopic surveillance. The assessment of grade of the gastritis including atrophic gastritis and IM was based on the updated Sydney System. Results: Chronic gastritis and active gastritis significantly decreased after H. pylori eradication in these patients (p < 0.05). After H. pylori eradication, the mean atrophy score declined from 2.4 (mean) to 1.9 in the corpus and from 2.3 to 1.6 in the antrum (p < 0.05). Furthermore, the grade of IM in the body significantly decreased from 1.9 to 1.4 during a 3-year follow-up after eradication of infection (p < 0.05). Conclusion: H. pylori eradication seems to improve gastric mucosal inflammation, atrophy, and corporal IM in the patients after EMR of EGC.