Identification and evaluation of premalignant gastric lesions associated with Helicobacter pylori infection

Abstract

Introduction: Helicobacter pylori infection is the main cause of gastroduodenal diseases (chronic gastritis, peptic ulcer and gastric cancer). In Guatemala few studies have been carried out on the prevalence of H. pylori and its relationship with gastrointestinal diseases, particularly with cancer.

Objective: To identify the presence of premalignant lesions (gastric atrophy, intestinal metaplasia and dysplasia) and their relationship with H. pylori infection in outpatients in gastroenterology units in two national hospitals in Guatemala City.

Methods: Histopathological and bacteriological diagnostic testings were performed by H & E and Giemsa stain, culture and biochemical identification, detection of specific antibodies by ELISA, molecular diagnosis by glmM gene amplification, and genotypification by PCR to identify vacA and cagA genes. Clinical and epidemiological data from patients, prevalence of H. pylori infection, and bacterium genotypification were analyzed.

Results: Among the studied patients, 293 (83%) presented some type of premalignant lesion. The most prevalent were gastric atrophy (70%), intestinal metaplasia (11%), and gastric dysplasia (2%). Seventeen percent of the patients did not have any premalignant lesions. The prevalence of H. pylori infection was 58%, and cagA gene was identified in 118 (57%) of the infected patients.

Conclusions: The majority of the patients presented gastric atrophy (70%), and 43.5% were infected by H. pylori, mainly with positive cagA strains. This finding confirms the importance of studying H. pylori and its relationship with gastric cancer.