[Is gastric carditis associated with antral gastritis in patients with non-ulcer dyspesia and Helicobatcer pylori infection?].

UNLABELLED: 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.