Skip to main content

Advertisement

SpringerLink
Log in

Association Between Gastric Atrophy and Helicobacter pylori Infection in Japanese Children: A Retrospective Multicenter Study

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

The purpose of this study was to determine whether Helicobacter pylori infection and mucosal inflammation result in gastric atrophy in Japanese children. A total of 196 patients ages 1–16 years were retrospectively studied: 131 patients were infected with H. pylori and 65 patients were uninfected. Antral (n = 196) and corpus biopsy specimens (n = 70) were investigated based on the Updated Sydney system. In both the antrum and corpus, H. pylori-infected patients showed significantly higher degrees of inflammation and activity of gastritis, compared with noninfected patients. The prevalence of grade 2 or 3 atrophy in the antrum was 10.7% in H. pylori-infected patients and 0% in the noninfected patients (P < .01) and in corpus 4.3% and 0%, respectively (P = .20). The frequency of intestinal metaplasia in the 2 study groups was 4.6% and 4.6% in the antrum and 0% and 4.2% in the corpus, respectively. Among H. pylori-infected patients, the antrum showed significantly higher degrees of H. pylori density, inflammation and activity of gastritis, and atrophy than the corpus. In the antrum, atrophy was significantly correlated with activity, whereas in the corpus, atrophy correlated with H. pylori density, inflammation, and activity. H. pylori-induced gastric inflammation can cause atrophy in Japanese children, predominantly in the antrum. It remains to be determined whether H. pylori-infected children with gastric atrophy are at increased risk for gastric cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Suerbaum S, Michetti P: Helicobacter pylori infection. N Engl J Med 347:1175–1186, 2002

    Article  CAS  PubMed  Google Scholar 

  2. Kato S, Sherman PM: What is new related to Helicobacter pylori infection in children and teenagers? Arch Pediatr Adolesc Med 159:415–421, 2005

    Article  PubMed  Google Scholar 

  3. Drumm B, Sherman P, Cutz E, Karmali M: Association of Campylobacter pylori on the gastric mucosa with antral gastritis in children. N Engl J Med 316:1557–1561, 1987

    CAS  PubMed  Google Scholar 

  4. Macarthur C, Saunders N, Feldman W: Helicobacter pylori, gastroduodenal disease, and recurrent abdominal pain in children. JAMA 273:729–734, 1995

    Article  CAS  PubMed  Google Scholar 

  5. Kato S, Nishino Y, Ozawa K, et al.: The prevalence of Helicobacter pylori in Japanese children with gastritis or peptic ulcer disease. J Gastroenterol 39:734–738, 2004

    PubMed  Google Scholar 

  6. Sherman PM: Peptic ulcer disease in children: diagnosis, treatment, and the implication of Helicobacter pylori. Gastroenterol Clin North Am 23:707–725, 1994

    CAS  PubMed  Google Scholar 

  7. Louw JA, Falck V, van Rensberg C, Zak J, Adams G, Marks IN: Distribution of Helicobacter pylori colonization and associated gastric inflammatory changes: difference between patients with duodenal and gastric ulcers. J Clin Pathol 46:754–756, 1993

    CAS  PubMed  Google Scholar 

  8. Meining A, Stolte M, Hatz R, et al.: Differing degree and distribution of gastritis in Helicobacter pylori-associated diseases. Virchow Arch 431:11–15, 1997

    CAS  Google Scholar 

  9. Genta RM, Hamner HW, Graham DY: Gastric lymphoid follicles in Helicobacter pylori infection: frequency, distribution, and response to triple therapy. Hum Pathol 24:577–583, 1993

    Article  CAS  PubMed  Google Scholar 

  10. Kuipers EJ, Uyterlinde AM, Pena AS, et al.: Long-term sequelae of Helicobacter pylori gastritis. Lancet 345:1525–1528, 1995

    Article  CAS  PubMed  Google Scholar 

  11. Correa P: Human gastric carcinogenesis: a multistep and multifactorial process. Cancer Res 48:6735–6740, 1992

    Google Scholar 

  12. Banatvals N, Mayo K, Megraud F, Jennings R, Deeks JJ, Feldman RA: The cohort effect and Helicobacter pylori. J Infect Dis 168:219–221, 1993

    Google Scholar 

  13. Blaser MJ, Chyou PH, Nomura A: Age at establishment of Helicobacter pylori infection and gastric carcinoma, gastric ulcer, and duodenal ulcer risk. Cancer Res 55:562–565, 1995

    CAS  PubMed  Google Scholar 

  14. Meining A, Behrens R, Lehn N, Bayerdorffer E, Stolte M: Different expression of Helicobacter pylori gastritis in children: evidence for a specific pediatric disease? Helicobacter 1:92–97, 1996

    CAS  PubMed  Google Scholar 

  15. Whitney AE, Gaurner J, Hutwagner L, Gold BD: Helicobacter pylori gastritis in children and adults: comparative histopathologic study. Ann Diagn Pathol 4:279–285, 2000

    CAS  PubMed  Google Scholar 

  16. Guarner J, Bartlett J, Whistler T, et al.: Can pre-neoplastic lesions be detected in gastric biopsies of children with Helicobacter pylori infection? J Pediatr Gastroenterol Nutr 37:309–314, 2003

    PubMed  Google Scholar 

  17. Joossens JV, Geboers J: Diet and environment in the etiology of gastric cancer. In Frontiers in gastrointestinal cancer. Levin B, Riddell RH (eds). New York, Elsevier, 1984, pp 167–183

    Google Scholar 

  18. Asaka M, Kimura T, Kudo M, et al.: Relationship of Helicobacter pylori to serum pepsinogens in an asymptomatic Japanese population. Gastroenterology 102:760–766, 1992

    CAS  PubMed  Google Scholar 

  19. Uemura N, Okamoto S, Yamamoto S, et al.: Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 345:784–789, 2001

    Article  CAS  PubMed  Google Scholar 

  20. Kato S, Ozawa K, Konno M, et al.: Diagnostic accuracy of the 13C-urea breath test for childhood Helicobacter pylori infection: a multicenter Japanese study. Am J Gastroenterol 97:1668–1673, 2002

    Article  PubMed  Google Scholar 

  21. Genta RM, Graham DY: Comparison of biopsy sites for the histopathologic diagnosis of Helicobacter pylori: a topographic study of H. pylori density and distribution. Gastrointest Endosc 40:342–345, 1994

    CAS  PubMed  Google Scholar 

  22. Dixon MF, Genta RM, Yardley JH, Correa P: Classification and grading of gastritis. The updated Sydney System. Am J Surg Pathol 20:1161–1181, 1996

    CAS  Google Scholar 

  23. Campbell DI, Warren BF, Thomas JE, Figura N, Telford JL, Sullivan PB: The African enigma: low prevalence of gastric atrophy, high prevalence of chronic inflammation in West African adults and children. Helicobacter 6:263–267, 2001

    Article  CAS  PubMed  Google Scholar 

  24. Guiraldes E, Pena A, Duarte I, et al.: Nature and extent of gastric lesions in symptomatic Chilean children with Helicobacter pylori-associated gastritis. Acta Paediatr 91:39–44, 2002

    Article  CAS  PubMed  Google Scholar 

  25. De Giacomo C, Fiocca R, Villani L, et al.: Helicobacter pylori infection and chronic gastritis: clinical, serological, and histologic correlations in children treated with amoxicillin and colloidal bismuth subcitrate. J Pediatr Gastroenterol Nutr 11:310–316, 1990

    PubMed  Google Scholar 

  26. Kato S, Takeyama J, Ebina K, Naganuma H: Omeprazole-based dual and triple regimens for Helicobacter pylori eradication in children. Pediatrics 100:e3, 1997

    Article  CAS  PubMed  Google Scholar 

  27. Sipponen P: Gastric cancer: a long-term consequence of Helicobacter pylori infection? Scand J Gastroenterol 29(Suppl 201):24–27, 1994

    Google Scholar 

  28. Rugge M, Correa P, Dixon MF, et al.: Gastric mucosal atrophy: interobserver consistency using new criteria for classification and grading. Aliment Pharmacol Ther 16:1249–1259, 2002

    Article  CAS  PubMed  Google Scholar 

  29. Genta RM: Recognizing atrophy: another step toward a classification of gastritis. Am J Surg Pathol 20(Suppl 1):23–30, 1996

    Google Scholar 

  30. Bozzola C, Boldorini R, Guidali P, Paracchini R, Rapa A, Oderda G: Mild infiltration in childhood Helicobacter pylori gastritis: a morphometric and morphologic analysis (abstract). Gut 51(Suppl II):A82, 2002

    Google Scholar 

  31. Cohen MC, Cueto R, Balcarce N, Donatone J, Drut R: Assessment of the Sydney System in Helicobacter pylori-associated gastritis in children. Acta Gastroenterol Latinoam 30:35–40, 2000

    CAS  PubMed  Google Scholar 

  32. Usta Y, Saltik-Temizel IN, Ozen H: Gastric atrophy and intestinal metaplasia in Helicobacter pylori infection (letter). J Pediatr Gastroenterol Nutr 38;548, 2004

    PubMed  Google Scholar 

  33. Jones NL, Shannon PT, Cutz E, Yeger H, Sherman PM: Increase in proliferation and apoptosis of gastric epithelial cells early in the natural history of Helicobacter pylori infection. Am J Pathol 151:1695–1703, 1997

    CAS  PubMed  Google Scholar 

  34. Ozawa K, Kato S, Sekine H, et al.: Gastric epithelial cell turnover and mucosal protection in Japanese children with Helicobacter pylori infection. J Gastroenterol 40:236–246, 2005

    Article  PubMed  Google Scholar 

  35. Drumm B, Day AS, Gold B, et al.: Helicobacter pylori and peptic ulcer: working group report of the second World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 39:S626–S631, 2004

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan

    Seiichi Kato MD, Kyoko Ozawa MD & Takanori Minoura MD

  2. Department of Gastroenterology, Social Insurance Shiga Hospital, Otsu, Japan

    Shigemi Nakajima MD

  3. Departments of Public Health, Tohoku University School of Medicine, Sendai, Japan

    Yoshikazu Nishino MD

  4. Sapporo Kohsei General Hospital, Sapporo, Japan

    Mutsuko Konno MD

  5. Morioka Children's Hospital, Morioka, Japan

    Shunichi Maisawa MD

  6. Kanagawa Prefecture Midwives and Nurses Training Hospital, Yokohama, Japan

    Shigeru Toyoda MD

  7. Osaka Medical Center for Maternal and Child Health, Osaka, Japan

    Norikazu Yoshimura MD

  8. Department of Pathology, Veterans Affairs Medical Center, Houston, Texas

    Ajula Vaid MD

  9. Division de Pathologie Clinique, Hopital Universitaire de Geneve, Geneve, Switzerland

    Robert M. Genta MD

  10. The Hershey Medical Center, P.O. Box 850, M.C. h045, Hershey, Pennsylvania, 17033, USA

    Seiichi Kato MD

Authors
  1. Seiichi Kato MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shigemi Nakajima MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yoshikazu Nishino MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kyoko Ozawa MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takanori Minoura MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mutsuko Konno MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shunichi Maisawa MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shigeru Toyoda MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Norikazu Yoshimura MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ajula Vaid MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Robert M. Genta MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seiichi Kato MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kato, S., Nakajima, S., Nishino, Y. et al. Association Between Gastric Atrophy and Helicobacter pylori Infection in Japanese Children: A Retrospective Multicenter Study. Dig Dis Sci 51, 99–104 (2006). https://doi.org/10.1007/s10620-006-3091-5

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-006-3091-5

Key Words

Search

Navigation