HELICOBACTER-PYLORI AND INCREASED EPITHELIAL-CELL PROLIFERATION - A RISK FACTOR FOR CANCER

Objective: Epidemiological studies have identified a link between Helicobacter pylori and gastric carcinoma. Epithelial cell proliferation is an indicator of risk of adenocarcinoma. We aimed to assess the effect of H. pylori on gastric epithelial cell proliferation. Subjects: A total of 124 patients were recruited and assigned to three study groups. Group 1 (control group) comprised 28 H. pylori-negative patients with normal gastric mucosa; group 2 comprised 28 H. pylori-negative patients with type C (chemically induced) gastritis and group 3 comprised 68 H. pylori-positive patients with type B (bacteria induced) gastritis. Four antral mucosal biopsy specimens were taken for cell proliferation analysis using the in vitro bromodeoxyuridine immunohistochemical technique. Ten entire gastric pits of more than 100 cells were counted per patient and the labelling index percentage (LI%) was calculated (the total number of proliferating cells expressed as a percentage of the total number of cells per pit). Results: Patients with H. pylori-positive gastritis had a significantly higher LI% (4.5+/-0.2%; P<0.05) than patients with H. pylori-negative gastritis (3.3+/-0.2%) or controls (2.9+/-0.1%). This increased cell proliferation was not associated with the severity of inflammation or the presence or absence of an ulcer on gastroscopy. Conclusion: Increased cell proliferation was associated with H. pylori infection, which may indicate that H. pylori is a risk factor in the pathogenesis of gastric cancer.