The impact of Helicobacterpylori eradication on reversing gastric mucosal atrophy and intestinal metaplasia: aprospective study

Abstract

：Objective To investigatethe effect of Helicobacter pylori (H. pylori) eradication on reversing gastric antrumatrophy and intestinal metaplasia (IM). Methods Biopsy specimens obtained from gastricantrum of patients who underwent gastroscopy were examined for pathology and the status ofH. pylori infection. The H. pylori infected patients who had chronic gastritis with antrumatrophy or IM were recruited and were divided into either H. pylori eradicated group (n=48)or control (non-eradicated) group (n=38). The gastroscopic follow-up was carried out at1 year and 5years. The specimens examined for changes of histology and reverse of gastricantrum and IM were obtained at the same site. Results The reversing rate of gastric antrumatrophy in H. pylori eradicated group was significantly higher than that in control group(37.1% vs. 12.0%). In H. pylori eradicated group, the reversing rate of gastric antrumatrophy at 5-year was significantly higher than that at 1-year, and it was higher inpatients aged below 45 years than those aged above 45 years.Whereas there was noassociation of reversing gastric antrum atrophy with follow-up time and age in controlgroup. However there was no difference in reversing rate of IM between two groups in 1- or5-year follow-up and H. pylori eradication. Conclusions H. pylori eradication can notreverse the IM of gastric antrum mucosa, but it can reverse the atrophy of gastric mucosa,which is associated with follow-up time and the age of patients. Therefore, H. pylori musthe eradicated as early as possible in H. pylori infected patients with gastric antrumatrophy.