Summary:
Helicobacter pylori is the most frequent cause of antral gastritis type B. Little is known about the
affection of the gastric cardia by inflammation associated with H. pylori infection.
Objective: Assess the status of morphological changes of the cardia in the presence of H. pylori
infection in patients with non-ulcer dyspesia.
Methods and patients: 251 consecutive dyspeptic patients with H.pylori infection were subjected
to endoscopic examination of the upper part of the gastrointestinal tract. Six biopsies were taken
(2 antrum, 2, corpus, 2 cardia) for histological (HaE) and microscopic (Giemsa) status, scored
according to the Sydney classification.
Results: Chronic inflammation and its activity reached similar values in the antrum and cardia,
the difference was not statistically significant (p >0.05). The findings of H.pylori and intestinal
metaplasia (IM) were higher in the antrum than in the cardia (p <0.05) similarly as atrophy and
hyperplasia of lymphatic tissue (p <0.01).
Significantly higher values were recorded in chronic inflammation, its activity and number of HP
in the antrum (p <0.001). The same applies to atrophy, IM, lymphoid follicles (p<0.01),dysplasia
and hyperplasia of lymphatic tissue (p <0.05).
Conversely chronic inflammation, activity and HP in the cardia were significantly higher than in
the corpus (p <0.001), similarly IM and lymphoid follicles (p <0.01), atrophy and dysplasia (p <0.05).
Conclusion:The incidence of carditis and antral gastritis associated with H.pylori infection was
equally expressed and reached a higher score than corporal gastritis. Inflammatory infiltration of
the cardia may play a crucial role in the pathogenesis of non-ulcer dyspepsia.
Abbreviations: GIT - gastrointestinal tract, GF - gastrofibroscopy, HP - Helicobacter pylori, NUD -
non-ulcer dyspepsia, H+E - Haematoxylin and eosin, CI - chronic inflammation, LF - lymhoid
follicles, IM - intestinal metaplasia, HF - hyperplasia of the foveolae, Dys - dysplasia, HLT -
lymphatic tissue hyperplasia, MALT-Ly - mucosa associated lymphoid tissue -lymphoma
Key words:
Carditis - Antral gastritis - Corporal gastritis - Helicobacter pylori
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