Helicobacter Pylori infection and associations according to OLGA and OLGIM stages

Abstract

Aim: Helicobacter pylori infection is a well known risk factor for chronic atrophic gastritis and intestinal metaplasia. There is evidence of frequent clear- ance of the H. pylori infection during progression of chronic atrophic gastritis. The aim of the study was to assess the association of H. pylori infection accord- ing to OLGA and OLGIM stages. Methods: We included 224 consecutive patients from January 2013 to June 2014 aged over 50 (male 28%, average age 61) undergoing FICE (gastroscope EG-590WR) endoscopy at Digestive diseases centre GASTRO, Riga, Latvia. Tar- geted biopsies were obtained at the locations of visually suspected lesions. If no changes were determined by FICE, random biopsies were performed in antrum, incisura and corpus according to Sydney-Houston protocol. Histology assess- ment was performed according to the updated Sydney System. Both OLGA and OLGIM were used and individuals classified accordingly. One trained general (S.I.) and two expert gastrointestinal pathologists (I.L.K. and D.J.), indepen- dently assessed all tissue sections. For all disconcordant cases a consensus on the atrophy and IM scores was subsequently reached. Results: The proportion of H. pylori positive and negative patients in relation to OLGA and OLGIM stages shown in Table 1. H. pylori positivity strongly decreased in advanced OLGA III/IV (P = 0.003) and OLGIM III/IV (P = 0.030) stages. The proportion of H.pylori positive and negative patients in relation to OLGA and OLGIM stages OLGAI-92 H.P+ 56 (61%) OLGIM I-59 H.P+ 39 (66%) OLGA II-34 H.P+18 (53%) OLGIM II-28 H.P+ 14 (50%) OLGA III-15 H.P+ 7 (47%) OLGIM III-17 H.P+ 7 (41%) OLGA IV-15 H.P+ 5 (33%) OLGIM IV-13 H.P+ 5 (38%) Conclusions: The results suggest of enhanced elimination of H. pylori during the development of the advanced OLGA III/IV and OLGIM stages.