Helicobacter Pylori-associated Gastritis Research Articles

Nodularity-like appearance in the cardia: novel endoscopic findings for Helicobacter pylori infection

Background and study aims Helicobacter pylori -associated nodular gastritis, which is associated with follicular lymphoid hyperplasia, is mainly recognized in the antrum. However, we have also observed nodularity-like appearance in the cardia. This study aimed to investigate the clinical significance of cardiac nodularity-like appearance in H. pylori -associated gastritis. Patients and methods Patients who underwent esophagogastroduodenoscopy and were evaluated for H. pylori infection for the first time were enrolled. A nodularity-like appearance in the cardia was defined as a miliary nodular appearance or scattered appearances of small circular whitish coloration. H. pylori infection was diagnosed according to serum anti- H. pylori antibody and the urea breath test or histology. Accuracy of the H. pylori infection diagnoses based on nodularity-like appearance were assessed. Results Among 265 patients, 42 patients (15.8 %) were diagnosed as positive for H. pylori . Cardiac nodularity-like appearance and antral nodularity were recognized in 25 and 15 patients, respectively. In accuracy of predicting H. pylori by cardiac nodularity-like appearance, specificity was 0.996, sensitivity was 0.571, positive predictive value was 0.960, negative predictive value was 0.925, and accuracy was 0.928. The sensitivity of cardiac nodularity-like appearance was significantly higher than that of antral nodularity ( P = 0.0284). Conclusions Cardiac nodularity-like appearance had a high accuracy rate for H. pylori infection diagnosis. Cardiac nodularity-like appearance was found more frequently than antral nodularity.

The treatment of helicobacter pylori-associated erosive lesions of gastroduodenal zone with the use of interactive learning technologies and rebamipide in young men

Purpose of the study. To evaluate the effectiveness of interactive teaching technologies and rebamipids in the complex therapy of erosive lesions of the gastroduodenal zone in young men.Material and research methods. Two groups of patients were examined. The observation group included 36 recruits with HP-associated gastritis with erosion (HSE) and duodenitis with erosion (DSE). Comprehensive treatment was used as a treatment: standard first-line triple therapy with the inclusion of rebamipide 100 mg 3 times a day for 14 days and interactive therapeutic training. The comparison group consisted of 18 patients with HP-associated GSE and DsE who received standard triple eradication therapy also for 14 days. The average age of the examined patients in the observation group was 21.0 ± 0.7 years, the comparison group was 20.1 ± 0.7 years.Results. The inclusion of Helicobacter pylori-associated gastritis and duodenitis with erosion of rebamipide and interactive learning technologies into the treatment regimen resulted in more effective relief of pain syndrome and dyspeptic manifestations in conscripts, restoration of mucus-forming and acid-producing functions of the stomach; to lower blood cortisol levels; reduce the degree of morphological activity of inflammation. There is a more effective eradication of Helicobacter pylori (91.7%) and epithelization of erosion (97.2%) in comparison with the standard scheme (88.9% and 94.4%, respectively). The use of interactive teaching technologies allowed to increase the level of medical activity and hygienic literacy (96.0% of recruits changed their diet, the nature of nutrition — 88.0%). The level of psycho-emotional status significantly improved after the treatment.Conclusion Combined therapy using rebamipide and interactive therapeutic training is effective in erosive lesions of the gastroduodenal zone in young men and increases patient adherence to treatment and leads to stabilization of psycho- emotional status.

Mucosal Th17 Cells Are Increased in Pediatric Functional Dyspepsia Associated with Chronic Gastritis.

Chronic gastritis is a common histologic finding in children with functional dyspepsia (FD). While Th17 cells have been implicated in other forms of gastritis, they have not been evaluated in chronic gastritis. The aim of the current study was to assess Th17 cells in children with FD with and without chronic gastritis. Densities were determined for Th17 cells, eosinophils, and mast cells, respectively, in both the gastric antrum and the duodenum. Densities were compared between five groups: FD with chronic gastritis (N = 20), FD without chronic gastritis (N = 20), Helicobacter pylori-associated gastritis (N = 10), Crohn's gastritis (N = 10), and normal controls (N = 10). Th17 densities were also compared between patients with and without early satiety. FD with chronic gastritis was associated with higher Th17 cell density as compared to normal controls and comparable to both H. pylori-associated gastritis and Crohn's gastritis. Eosinophil and mast cell densities were higher in FD patients with chronic gastritis as compared to either FD without gastritis or normal controls. Th17 density was higher in patients reporting early satiety but not in those with epigastric pain. FD with chronic gastritis is associated with higher Th17 cell, eosinophil, and mast cell density as compared to FD without chronic gastritis or normal controls. Chronic gastritis demonstrated Th17 cell density similar to that seen in other conditions where Th17 cells are believed to play a pathogenic role. Th17 cells may represent another therapeutic target in these patients.

The use of CNFA lectin in the diagnosis of precancerous changes in the gastric mucosa in patients with Helicobacter pylori-associated chronic gastritis

The use of CNFA lectin in the diagnosis of precancerous changes in the gastric mucosa in patients with Helicobacter pylori-associated chronic gastritis

1928 A Rare Case of Hematemesis Due to a Large Gastric Pyloric Gland Adenoma

INTRODUCTION: Accounting for less than 3% of all gastric polyps, pyloric gland adenomas (PGAs) are rare tumors that usually arise from the stomach or, less commonly, the esophagus, duodenum, pancreas, or gallbladder. PGAs rarely cause symptoms and hematemesis as the presenting symptom has not been previously described in the literature. We present a rare case of hematemesis secondary to a large gastric PGA. CASE DESCRIPTION/METHODS: A 94 year-old female with a history of hypothyroidism and occasional nonsteroidal anti-inflammatory drug-use presented with hematemesis and hematochezia. She complained of acute-onset nausea, vomiting and diarrhea. Patient was hemodynamically stable at the time of presentation. Admission laboratory studies were significant for a hemoglobin of 7.2 mg/dl compared to 11.4 mg/dl two weeks prior. An esophagogastroduodenoscopy (EGD) was performed and revealed a 4 cm polyp-appearing mass with a short stalk in the mid-greater curvature of the body of the stomach. The tissue was friable and spontaneously bled with minimal friction from the snare, thus likely the etiology for the patient’s symptoms. The polyp was removed in piecemeal fashion using hot snare. Submucosal epinephrine was injected and four DuraClips were deployed over the polypectomy site. The patient declined to undergo a colonoscopy. Following her EGD, patient did not exhibit any additional signs or symptoms of continued bleeding and was discharged home in good condition. Pathology revealed pyloric gland adenoma with high-grade dysplasia. DISCUSSION: This case emphasizes the need for increased awareness regarding the presence of PGAs. These lesions have been shown to arise in chronically damaged mucosa and were associated with autoimmune gastritis in 33.9% of patients, active Helicobacter pylori-associated gastritis in 30.2% of patients, and normal gastric mucosa in only 3.8% of patients. Patients are usually elderly females with an average age of 75 years; though signs and symptoms are variable, laboratory evaluation frequently reveals anemia. This diagnosis is rare but the malignant potential was reported between 12 to 30% of cases in two large studies making improved classification and management necessary.

Challenges of Accurate Diagnosis of Helicobacter pylori in Iran

Background: Helicobacter pylori-associated gastritis is regarded as the most prevalent gastrointestinal infection, as well as the major cause of several other diseases. Despite being discovered over 30 years ago, no golden diagnostic method has yet been suggested for this microorganism. Objective: The present study aimed to compare two common diagnostic methods of histology and serology. Materials and Methods: This cross-sectional study began in July, 2016, and was conducted at Imam Jafar Sadegh Hospital (a university hospital) in Maybod, Yazd, Iran, on 70 patients. All the patients underwent endoscopy, and biopsy samples were taken for histology, as well as blood samples for ELISA test. Finally, sensitivity, specificity, NPV (negative predictive values), and PPV (positive predictive values) were calculated and analyzed. Results: The sensitivity, specificity, accuracy, PPV, and NPV of the ELISA method with histology as the gold standard were 87.5%, 36.9%, 54.2%, 42%, and 85%, respectively. Still, the histology method appears to be the most reliable test for the diagnosis of H. pylori in Iran. Conclusion: Regarding the high prevalence of H. pylori in Iran, the present study recommends the use of histology as a diagnostic method in combination with other diagnostic methods for detecting H. pylori infection.

Prevalence of barrett's esophagus, its relationship with chronic Helicobacter pylori-associated gastritis, atrophy and metaplasia of gastric mucosa

The aim - to identify the frequency of Helicobacter pylori infection, atrophic and metaplastic changes in the gastric mucosa in patients with Barrett's esophagus.
 Materials and methods. A retrospective study of 7392 cases of complex esophagogastroscopy with a biopsy of the epithelium of the mucous membrane of the esophagus and stomach, followed by a morphological study, was conducted on the basis of the Medical Centre “Oberig” clinic for the period 2010-2018. Statistical data was performed using the MedStat package. To assess the prevalence of changes in the esophagus and stomach, a 95% confidence interval was calculated using the Fisher angular transformation method. The probability of differences between group averages and relative values ​​was determined using the method of parametric statistics by calculating the t-Student criterion. The difference between the average values ​​was considered significant at p <0.05. To compare the frequencies in different groups, the Pearson chi-square test was used.
 Results. Endoscopically cylindrical columnar metaplasia of the esophagus epithelium was detected in 2994 patients (40.5% CI 39.4% -41.6% at a significance level of p = 0.05). In a histological examination, esophageal epithelial metaplasia was confirmed in 2910 patients (39.4% CI 38.3%-40.5%). 876 cases of gastric-type esophagus epithelial metaplasia were diagnosed (30.1%, CI 28.4-31.5%); 2034 cases of intestinal type metaplasia (69.9%, CI 68.2-71.6%). Histological examination of biopsy samples of the gastric mucosa in 5640 (76.3%, CI 75.3-77.3%) patients revealed atrophy of the gastric mucosa. In 2532 cases (34.3%, CI 33.2-35.3%), complete and incomplete intestinal metaplasia of the gastric epithelium was diagnosed. In 4524 (61.2%, CI 60.1-62.3%) patients, Helicobacter pylori was detected. In the presence of H. pylori, gastric esophageal epithelial metaplasia was detected in 510 of 3558 (14.3%, CI 13.2-15.5%, p = 0.05), intestinal metaplasia of the esophagus epithelium - in 966 of 4014 (24.1% CI 22.8 -25.4%, p = 0.05).
 Conclusion. Esophageal epithelial metaplasia is a common pathology, accounting for 39.4% among patients who underwent esophagogastroscopy. The presence of a strong connection between intestinal metaplasia of the epithelium of the esophagus and atrophy of the gastric mucosa with intestinal metaplasia of the epithelium of the stomach was found. Esophageal epithelial metaplasia is significantly less common with Helicobacter pylori gastritis, therefore the presence of H. pylori has a protective effect on the occurrence of esophageal epithelial metaplasia.

Differential diagnosis of Helicobacter pylori-associated gastritis with the linked-color imaging score

BackgroundHelicobacter pylori (H. pylori) infection in gastric mucosa is the main risk factor for gastric cancer. The purpose of this study was to assess the value of the linked-color imaging (LCI) score for the identification of H. pylori-associated gastritis. MethodsA total of 358 patients were enrolled in the study. H. pylori was positive in 127 cases and negative in 231 cases. Redness of fundus glands, granular erosion, purple mucus (+) and mucus lake turbidity were investigated by the LCI mode of endoscopy. Logistic regression was used to screen the observation indexes and their relative partial regression coefficients, which were helpful for the differential diagnosis of H. pylori infection. Then, each observation index was scored according to the partial regression coefficient. ResultsUsing a total scores of 3.5 as the cut-off value, the sensitivity and specificity were 83.8% and 99.5%, respectively, for the differential diagnosis of H. pylori gastritis. The area under the curve was 95.3%. ConclusionsThe LCI score showed high sensitivity and specificity for the differential diagnosis of H. pylori-associated gastritis and is an effective method for identifying H. pylori infection in gastric mucosa.

The restoration of stomach mucosa in patients with chronic erosive Helicobacter pylori-associated gastritis

Objective — to investigate efficacy of preparation of pro-vitamin B5 and vitamin U in the complex therapy of patients with chronic erosive gastritis, associated with H. pylori, combined with the pancreas excretory insufficiency, established by the morphological parameters.Materials and methods. The study involved 28 patients with H. pylori-associated gastritis combined with the pancreas excretory insufficiency, who were under regular medical check-up and supervision of a family doctor in the Ternopil City Municipal Institution Center of primary health care. The patients were allocated into two groups: the main (n = 1`6) and control (n = 12) groups. All patients received 10-days therapy with pantoprazole (Controloc, Nolpaza, Pantasun or other) in a dose of 40 mg twice a day, amoxicillin in a dose of 1000 mg (or metronidazole in a dose of 500 mg) twice a day, clarithromycin in a dose of 500 mg twice a day; patients of the main group received additional vitamin complex (Doctovit) 2 tablets a day after meals for over 2 months. At the baseline and 2 months after the treatment start, all patients underwent eso-gastroduodenoscopy, urease H. pylori test and biopsy with histological examination on 5 sites.Results. The total dynamics of improvement of the stomach mucosa morphological condition in the 1st group of patients was 0.9 points versus 1.6 points in the 2nd group of patients, which was 17 % and 32 %, respectively (p < 0.05). This testifies the efficacy and proves advisability to use this vitamin complex in the treatment and rehabilitation of patients with chronic gastritis, combined with the pancreas excretory insufficiency.Conclusions. In the complex treatment of patients with chronic gastritis, combined with the pancreas excretory insufficiency, it is advisable to use the complex of pro-vitamin B5 and vitamin U.

Клинико-функциональные особенности больных хроническим панкреатитом и сопутствующим helicobacter pylori-ассоциированным гастритом

Клинико-функциональные особенности больных хроническим панкреатитом и сопутствующим helicobacter pylori-ассоциированным гастритом

Genetic polymorphisms in TLR1, TLR2, TLR4, and TLR10 of Helicobacter pylori-associated gastritis: a prospective cross-sectional study in Thailand

The toll-like receptors (TLRs) mediate the recognition of Helicobacter pylori and initiate the innate immune response to infection. We hypothesized those genetic polymorphisms in the TLR1, TLR2, TLR4, and TLR10 influence bacterial infection, affecting susceptibility H. pylori to disease outcomes. Genomic DNA was extracted and genotypes of TLR1 (rs4833095), TLR2 (rs3804099 and rs3804100), TLR4 (rs10759932), and TLR10 (rs10004195) polymorphism were detected by the TagMan single-nucleotide epolymorphisms genotyping assay using the real-time PCR hybridization probe method. The TLR1 (rs4833095), C allele and the TLR10 (rs10004195), A allele frequency was significantly increased risk in the H. pylori infection group (odds ratio=1.76, 95% confidence interval=1.84-2.15, P=0.01 and odds ratio=1.81, 95% confidence interval=1.18-3.26, P=0.04, respectively). The TLR1 (rs4833095), C allele and TLR10 (rs10004195), A allele are susceptible TLRs polymorphisms in the Thai population. These findings suggest that TLR1 rs4833095 and TLR10 rs10004195 may play crucial roles in H. pylori susceptibility and gastric pathogenesis.

Guilt by association: intestinal metaplasia does not progress to gastric cancer.

This review integrates the new thinking about relationships between gastric cancer and intestinal metaplasia/pseudopyloric metaplasia (SPEM). We address whether recent studies have closed or widened the knowledge gap regarding gastric cancer pathogenesis in mice or humans. Recent studies in mouse models have provided a variety of new insights into the cellular origin and progression of events resulting in gastric cancer. Many suggest a direct transformation from intestinal metaplasia/pseudopyloric metaplasia/SPEM to gastric cancer. However, results from different investigator and models are conflicting and often describe events not present in studies in humans. Both Helicobacter pylori-associated and autoimmune gastritis may produce gastric atrophy with extensive intestinal metaplasia and an abnormal gastric microbiome. However, only H. pylori gastritis carries a risk for adenocarcinoma. The differences reported with mouse models can best be explained as the results of different models of regeneration and repair rather than as models of gastric cancer. Overall, the data remains consistent with the original hypothesis that gastric cancer results from increased genetic instability of gastric stem cells rather than a direct transition from metaplasia to cancer. Intestinal metaplasia, pseudopyloric metaplasia, and SPEM have all been falsely accused based on guilt by association.

Orbital Swelling as the Presenting Symptom of Gastric Adenocarcinoma

Gastric cancer is one of the most common malignancies in the world, with liver, peritoneum, lung, and bone being the most common sites of metastasis. Orbital metastasis from gastric adenocarcinoma is uncommon and can be easily misdiagnosed as a cellulitis or other infiltrative disorder. A 57-year-old male with history of cognitive delay presented with blurry vision, pain, and swelling around the right eye for one week. Review of systems was pertinent for epigastric pain, nausea, and weight loss. Physical examination was significant for right eye proptosis, periorbital soft tissue swelling, scleral icterus, jaundice, and cervical lymphadenopathy. Computed tomography of the orbits demonstrated bilateral coronal and intra-conal masses inseparable from the optic nerves. Biopsy of the right orbital lesion demonstrated mucinous tumor cells positive for CAM 5.2, CDX 2, and CEA-p. Computed tomography of the abdomen and pelvis demonstrated irregular thickening and hyper-enhancement of the distal gastric body and antrum with bulky lymphadenopathy of the retroperitoneum. ERCP and EGD were attempted; EGD demonstrated a large, deep, necrotic and ulcerated area of the lesser curvature extending into the proximal duodenum, causing deformity and narrowing of the antrum. ERCP was terminated as the endoscope could not be advanced past the gastric mass. Biopsy of the ulcer demonstrated poorly differentiated adenocarcinoma with signet ring cell features and Helicobacter pylori-associated gastritis. A final diagnosis of stage IV mucinous gastric adenocarcinoma was made. Due to his functional level and stage of disease the patient opted to be discharged home with hospice care. Orbital metastasis is a very rare complication of gastric adenocarcinoma, usually occurring late in the course. The most common presenting symptoms include diplopia, pain, and visual loss, while proptosis, strabismus, and vision impairment are the most frequent clinical signs. This case represents a variable presentation of gastric adenocarcinoma that should be kept in the differential of a patient presenting with orbital swelling and alarm symptoms, such as unexplained weight loss, abdominal pain, bloating, or jaundice. Physicians should be aware of the metastatic potential of gastrointestinal malignancy to the eye as these lesions can precede systemic manifestations. A complete ocular examination and comprehensive systemic survey are essential to the work-up of orbital swelling.2613_A Figure 1. Computed tomography of orbits demonstrating intraconal medial rectus muscle mass.2613_B Figure 2. Gastric adenocarcinoma as seen through endoscopy.2613_C Figure 3. Gastric adenocarcinoma as seen through endoscopy.

The role of the CagA gene in the occurrence of the inflammatory response of the gastric mucosa in patients with chronic Helicobacter pylori-associated gastritis

Currently, Helicobacter pylori infection (H. pylori) is recognized as one of the most important risk factors for gastrocarcinogenesis. It is known that this infection does not directly cause neoplastic changes in the gastric mucosa, and this is due to a number of consecutive events due to the long persistence of the pathogen in the human body. The initial stage of this cascade, of course, is the inflammatory response, due to the body’s ability to adapt to extraneous infection, which is the inevitable result of the interaction of H. pylori with cells of the gastric epithelium. This direct damaging effect is enhanced by the production of vacuolating cytotoxin and the release of products of the cytotoxin-associated CagA gene, which, at a pathomorphological level, is manifested by inflammatory infiltration of the gastric mucosa (GM) to some extent. On the relationship between the degree of contamination and the activity of the inflammation of the GM in people infected with the CagA strain, today there are different, often conflicting opinions, which is why in this work we set the goal of establishing the relationship between the nature of the inflammatory response and the presence of the CagA gene in H. pylori- infected patients. The purpose of the study is to determinate the relationship between the nature of the inflammatory response and the genetic features of the H. pylori strain (CagA genotype).We examined 365 patients, among whom 40 people were included in the control group (18 women and 22 men, whose average age was 45,33±15,46 and 42,82±12,31, respectively) without any gastroenterological pathology in the anamnesis , patients with chronic non-atrophic gastritis (188 people) and chronic atrophic gastritis (137 people). A close relationship was established between the presence of the CagA gene, activity and the degree of contamination for chronic non-atrophic gastritis: for a low degree of contamination, Fisher’s exact test was = 0.002, p<0.05, for a moderate degree - 0.012, p<0.05, for a high degree - 0,012, p<0.05. Accordingly, in chronic atrophic gastritis: for a low degree of contamination Fisher’s exact test = 0.011, p<0.05, for a moderate degree - 0.003, p<0.05, for a high degree - 0.001, p<0.05. There is also a close relationship between the degree of contamination and the activity of chronic gastritis: in patients with a high degree of contamination, CG activity was determined, as a rule, for stage 2-3. In our study, the inflammatory response depended on the presence or absence of the H. pylori strain in the patient, which contains the CagA genotype, which, in our opinion, plays a key role in triggering a cascade of inflammatory changes in the GM and progression of chronic gastritis.

A study of symptoms, eradication rates, and the degree of atrophy in patients with Helicobacter pylori-associated gastritis

A study of symptoms, eradication rates, and the degree of atrophy in patients with Helicobacter pylori-associated gastritis

Treatment of Helicobacter pylori-associated gastritis using traditional Chinese medicine

Abstract Helicobacter pylori is a pathogenic bacterium with strong pathogenicity, which can induce chronic gastritis and peptic ulcer in addition to causing gastric mucosal atrophy and intestinal metaplasia after longterm infection. It is even associated closely with the occurrence of gastric cancer and mucosa-associated lymphoid tissue lymphoma. Recently, the incidence of H.pylori-associated gastritis has increased rapidly worldwide, especially in China. The prevention and treatment of H. pylori infection has become an urgent issue to be resolved by the medical community. Traditional Chinese medicine and the combination of traditional Chinese medicine and Western medicine have recently shown unique advantages in the treatment of H.pylori–associated gastritis. The progress in this area is summarized in this review.

Tu1282 - Placenta Derived Mesenchymal Stem Cells Afforded Rejuvenation of Helicobacter Pylori-Associated Atrophic Gastritis Much Better than Other Kinds of MSC

Tu1282 - Placenta Derived Mesenchymal Stem Cells Afforded Rejuvenation of Helicobacter Pylori-Associated Atrophic Gastritis Much Better than Other Kinds of MSC

Glutathione peroxidase level in patients with Helicobacter pylori-associated gastritis

Helicobacter pylori (H. pylori) associated with the generation of reactive oxygen species (ROS), with leads to oxidative stress in the gastric mucosa. GPX is one of human antioxidative defense system allows the elimination of excess ROS. A cross-sectional study was in 80 consecutive gastritis patients who came to the endoscopic unit of Adam Malik General Hospital and PermataBunda Hospital in Medan, Indonesia, from May–September 2017, to determine the difference of GPX serum level between positive and negative infected H. pylori. the diagnosis of gastritis used Histopathology. Rapid urease test for diagnosis of H. pylori infection. Serum samples were obtained to determined circulating GPX. It used Univariate and bivariate analysis (Mann Whitney U test). There were 50 patients (62.5%) infected with H. pylori. GPX levels in patients with positive H. pylori gastritis were lower than those of negative H. pylori but did not differ significantly. In conclusion, there were no significant differences in GPX level between positive and negative infected H. pylori patients.

Benign and malignant gastroduodenal diseases associated with Helicobacter pylori: a narrative review and personal remarks in 2018.

The subject of Helicobacter pylori continues to elicit worldwide interest in many research fields. Epidemiological data suggest that the prevalence of the infection is decreasing in Western/developed countries and even in some developing regions, but this is masked by the high prevalence in the most populous regions. Chronic gastritis, caused invariably by the bacterium, was again classified in Kyoto and Helicobacter pylori-associated gastritis was included as a distinct entity. The prevalence of peptic ulcers is decreasing, but bleeding ulcers are a challenging problem, with stable mortality levels even in the endoscopic era. With the extended use of endoscopy, gastric polyps (GP) have become more prevalent: some are associated with the infection, some are not. Autoimmune and Helicobacter-induced gastritis can share common pathogenetic mechanisms. Gastric cancer (GC) is ranked highly on mortality lists worldwide. Its surgical treatment has registered some progress though. Little, if any improvement has been achieved in the medical treatment of advanced GC. With proper organization, GC seems a preventable disease. In spite of many guidelines, the Pan-European registry of Helicobacter pylori management shows that eradication rates obtained in many places are suboptimal. A new therapeutic regimen was compiled with promising pilot results. The results obtained with vonaprazan are limited to Asia. New avenues of both antibiotic and non-antibiotic treatments are expected to accelerate the eradication of this ulcerogenic and carcinogenic bacterium.

Altered regulation of Ure A and β-catenin gene expression levels in Helicobacter pylori-associated chronic gastritis

Altered regulation of Ure A and β-catenin gene expression levels in Helicobacter pylori-associated chronic gastritis