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. 2002 Feb;55(2):133-7.
doi: 10.1136/jcp.55.2.133.

Helicobacter pylori associated gastric diseases and lymphoid tissue hyperplasia in gastric antral mucosa

X Y Chen  1 , W Z Liu, Y Shi, D Z Zhang, S D Xiao, G N J Tytgat
Affiliations

Helicobacter pylori associated gastric diseases and lymphoid tissue hyperplasia in gastric antral mucosa

X Y Chen et al. J Clin Pathol. 2002 Feb.

Abstract

Aim: To investigate the relation between Helicobacter pylori associated gastroduodenal diseases and lymphoid tissue hyperplasia in the antral mucosa and to pursue its evolution after eradication of H pylori.

Methods: Gastric antral biopsy specimens were obtained from 438 patients with H pylori positive gastroduodenal diseases (185 chronic gastritis, 69 gastric ulcer, and 184 duodenal ulcer) and 50 H pylori negative healthy controls. Lymphoid follicles and aggregates were counted and other pathological features were scored according to the updated Sydney system for classification of chronic gastritis. After a course of anti-H pylori treatment, biopsy specimens were obtained at four to six weeks, 12 months, and 24 months in the chronic gastritis patient group.

Results: The total prevalence of lymphoid follicles and aggregates in the biopsies was 79.9% (350 of 438; 95% confidence intervals (CI), 0.76 to 0.84). The prevalence and density of lymphoid follicles and aggregates were significantly different in the various gastroduodenal diseases. The highest prevalence (89.9%; 95% CI, 0.83 to 0.97) and density (0.82) of lymphoid follicles and aggregates occurred in patients with gastric ulcers. The lowest prevalence of lymphoid follicles and aggregates was found in patients with chronic gastritis (74.6%; 95% CI, 0.68 to 0.81), and the lowest density of lymphoid follicles and aggregates (0.56) was seen in patients with duodenal ulcers. The prevalence and density of lymphoid follicles and aggregates correlated strongly with the activity and severity of gastric antral mucosal inflammation. The eradication of H pylori resulted in a decrease in the prevalence and density of lymphoid follicles and aggregates.

Conclusion: The prevalence and density of lymphoid follicles and aggregates in gastric antral mucosal biopsies correlated closely with H pylori infection.

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Figures

Figure 1
Figure 1
The prevalence of lymphoid follicles and aggregates in the antral mucosa in the different groups of patients. CG, chronic gastritis; DU, duodenal ulcer; GU, gastric ulcer. *Values are the number of patients with lymphoid follicles and aggregates/total number of patients in that group.
Figure 2
Figure 2
The density of lymphoid follicles and aggregates in the antral mucosa in the different groups of patients. CG, chronic gastritis; DU, duodenal ulcer; GU, gastric ulcer. *The number of biopsy specimens with lymphoid tissue hyperplasia/the total number of biopsy specimens in that group.
Figure 3
Figure 3
The relation between the density of lymphoid follicles and aggregates and disease activity in the chronic gastritis group.
Figure 4
Figure 4
The relation between the density of lymphoid follicles and aggregates and the severity of inflammation in the chronic gastritis group.
Figure 5
Figure 5
The relation between the density of lymphoid follicles and aggregates and atrophy or intestinal metaplasia (IM) in the chronic gastritis group. Solid line, atrophy; dotted line, IM.
Figure 6
Figure 6
Changes in the prevalence of lymphoid follicles and aggregates in the antral mucosa in the chronic gastritis group during the two years of follow up. Hp+, Helicobacter pylori positive; Hp−, H pylori negative. *Values are the number of patients with lymphoid tissue hyperplasia/total number of patients in that group.
Figure 7
Figure 7
The changes in the prevalence of lymphoid follicles and aggregates in the antral mucosa in the chronic gastritis group during the two years of follow up. Hp+, Helicobacter pylori positive; Hp−, H pylori negative. *Values are the number of biopsy specimens with lymphoid tissue hyperplasia/total number of biopsy specimens examined in that group.
Figure 8
Figure 8
Severe chronic inflammation with a high prevalence of lymphoid follicles accompanying moderate to severe glandular atrophy in the gastric mucosa.
See this image and copyright information in PMC

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