Comparison of precancerous conditions: atrophy and intestinal metaplasia in Helicobacter pylori gastritis among Chinese and Dutch patients

• Published in: Journal of clinical pathology Vol. 54; no. 5; pp. 367 - 370
• Main Authors: Chen, X-Y, van der Hulst, R W M, Shi, Y, Xiao, S-D, Tytgat, G N J, Ten Kate, F J W
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Association of Clinical Pathologists 01.05.2001; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Adolescent; Adult; Age Distribution; Age groups; Age of Onset; Aged; Analysis; atrophy; Atrophy - ethnology; Biological and medical sciences; Biopsy; China; China - epidemiology; discrepancy/prevalence; Endoscopy; Evaluation; Female; Gastric cancer; Gastritis; Gastritis - complications; Gastritis - ethnology; Gastroenterology. Liver. Pancreas. Abdomen; Helicobacter infections; Helicobacter Infections - complications; Helicobacter Infections - ethnology; Helicobacter pylori; Helicobacter pylori infected; Histopathology; Humans; Infections; intestinal metaplasia; Male; Medical sciences; Metaplasia; Metaplasia - ethnology; Middle Aged; Netherlands - epidemiology; Precancerous Conditions - ethnology; Precancerous Conditions - etiology; Prevalence; Statistical analysis; Stomach - pathology; Stomach Neoplasms - ethnology; Stomach Neoplasms - etiology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; the Netherlands; Tumors; Ulcers; Netherlands; China; United States; Human; Stomach; Carcinoma; Premalignant lesion; Prevalence; Spirillales; Spirillaceae; Malignant tumor; Gastroscopy; Gastritis; Infection; Atrophy; Pathology; Helicobacter pylori; Intestinal metaplasia; Bacteriosis; Digestive diseases; Bacteria; Chinese; Endoscopy; Dutch; Comparative study; Gastric disease
• ISSN: 0021-9746; 1472-4146
• DOI: 10.1136/jcp.54.5.367

Aim—Atrophy and intestinal metaplasia (IM) as precancerous conditions consistently begin in the antrum and are most severe along the lesser curvature. The aim of this study was to investigate discrepancies in the prevalence, the severity of atrophy, and IM in antral mucosa of Helicobacter pylori infected gastritis and difference in age of onset among Chinese and Dutch patients. Methods—Two hundred and sixty five Chinese patients and 261 Dutch patients with H pylori infection were enrolled. The degrees of atrophy and IM were graded according to the updated Sydney system. Results—The overall prevalences of atrophy and IM were lower in Dutch patients (42% and 26%, respectively) than in Chinese patients (52% and 32%, respectively). Only the difference in atrophy reached significance (p = 0.028). However, in both Chinese and Dutch patients, the degrees of atrophy and IM were low and severe degrees were rare. The mean ages of Chinese and Dutch patients with atrophy and IM were higher than those without atrophy and IM (with atrophy (Chinese patients): mean, 42.12; SD, 9.80; with IM (Chinese patients): mean, 42.56; SD, 9.96; with atrophy (Dutch patients): mean, 55.16; SD, 12.20; with IM (Dutch patients): mean, 57.79; SD, 11.13; without atrophy (Chinese patients): mean, 39.71; SD, 10.16; without IM (Chinese patients): mean, 40.19; SD, 9.99; without atrophy (Dutch patients): mean, 45.70; SD, 12.44; without IM (Dutch patients): mean, 46.89; SD, 12.68). Atrophy and IM occurred earlier and were more severe in Chinese patients, with both reaching a peak value in patients over 60 years. Conclusions—There are geographical differences in the prevalence and severity of H pylori infected gastritis, in particular with respect to atrophy and IM, which suggests that infection with H pylori occurs earlier in life and has a higher prevalence in China.