EFFECT OF ERADICATION OF HELICOBACTER-PYLORI INFECTION ON GASTRIC EPITHELIAL-CELL PROLIFERATION

Helicobacter pylori infection has been linked with gastric carcinoma. Epithielial cell proliferation is an indicator of cancer risk. The aim of this study was to assess gastric epithelial cell proliferation before and after eradication therapy and to assess the efficacy of treatment of H. pylori infection using lanzoprazole and clarithromycin. Twenty-three patients with H. pylori-associated gastritis were treated with lanzoprazole 30 mg daily for four weeks and clarithromycin 500 mg three times a day for two weeks. Antral mucosal biopsies were taken for gastric epithelial cell proliferation analysis using the in vitro bromodeoxyuridine (BrdU) immunohistochemical technique before and four weeks after eradication therapy. Labeling index percent (LI%) was calculated as the percent ratio of proliferating cells to the total number of cells in the gastric pit. Efficacy of treatment was assessed in 16 subjects. Eight were negative for H. pylori infection 28 days after therapy and in eight patients H. pylori infection was not eradicated. The eradication rate for the regimen was 50%. Cell kinetics were assessed in 19 subjects who completed treatment. Patients with H. pylori infection had a significantly higher LI% compared to normal (N = 19, LI%: 5.01 +/- 0.3 vs 3.2 +/- 0.2, N = 29). Eradication of H. pylori infection significantly reduced epithelial cell proliferation (N = 9, LI%: 5.2 +/- 0.4 to 3.2 +/- 0.8, P < 0.001), whereas it was unaltered in those whose infection was not eradicated (N = 10, LI%: 4.8 +/- 0.4 to 5.5 +/- 0.5, P = 0.18). Eradication of H. pylori reduces gastric epithelial cell proliferation to normal levels and may reduce the long-term the risk of gastric carcinoma.