Helicobacter pylori and histopathological changes of gastric mucosa in Uganda population with varying prevalence of stomach cancer.

OBJECTIVES Study the pathological changes in gastric mucosa of Nyarwanda, Nkole (both with high prevalence of stomach cancer) and Ganda (with low prevalence of this cancer) ethnic groups in the presence of Helicobacter pylori (H. pylori) infection. RESEARCH QUESTION Do pathological changes accompanying H. pylori infection explain the varying prevalence of stomach cancer in these populations? DESIGN Retrospective cross sectional study. SUBJECTS A total of 114 patients of the above ethnic groups with upper gastrointestinal symptoms who underwent endoscopic biopsy examination between January 1996 and June 2002 formed the basis of this study. RESULTS The severity of gastritis correlated with the presence of H. Pylori in Ganda and Nyarwanda but not in Nkole. Intestinal metaplasia (IM) was observed in Nyarwanda and Nkole and in some of these cases there was H. pylori. Gastric atrophy (GA) was also commonly observed in Nkole and Nyarwanda and H. pylori was detected more in the severe form of GA. Lymphoid follicle formation was not associated with H. pylori infection in all study groups. CONCLUSION The major histological features relating stomach cancer to H. pylori in this study were presence of the infection in IM and GA that was observed mainly in Nyarwanda and Nkole. The lack of association between presence of lymphoid follicle and H. pylori infection probably explains the rarity of MALT lymphoma in Africa as these tumours are said to arise from H. pylori associated lymphoid follicles.

[1]  D. Forman,et al.  Trends over time in Helicobacter pylori gastritis in Kenya , 2000, European journal of gastroenterology & hepatology.

[2]  R. Herrera-Goepfert,et al.  Helicobacter pylori and lymphoid follicles in primary gastric MALT-lymphoma in Mexico. , 1996, Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion.

[3]  M. Stolte,et al.  Different Expression of Helicobacter pylori Gastritis in Children: Evidence for a Specific Pediatric Disease? , 1996, Helicobacter.

[4]  E. Kuipers,et al.  Long-term sequelae of Helicobacter pylori gastritis , 1995, The Lancet.

[5]  D. Graham,et al.  Gastric lymphoid follicles in Helicobacter pylori infection: frequency, distribution, and response to triple therapy. , 1993, Human pathology.

[6]  E. Fontham,et al.  High prevalence and persistence of cytotoxin-positive Helicobacter pylori strains in a population with high prevalence of atrophic gastritis. , 1992, The American journal of gastroenterology.

[7]  M. Blaser,et al.  Prevalence of Helicobacter pylori infection and histologic gastritis in asymptomatic persons. , 1989, The New England journal of medicine.

[8]  J. Cook,et al.  Evaluation of staining methods for identifying Campylobacter pylori. , 1988, American journal of clinical pathology.

[9]  J. Bogaerts,et al.  Campylobacter pylori, gastritis, and peptic ulcer disease in central Africa. , 1987, British medical journal.

[10]  B. Rathbone,et al.  Simplified techniques for identifying Campylobacter pyloridis. , 1986, Journal of clinical pathology.

[11]  Hiza Pr.  Malignant disease in Tanzania. , 1976 .

[12]  S. Tannenbaum,et al.  A MODEL FOR GASTRIC CANCER EPIDEMIOLOGY , 1975, The Lancet.

[13]  H. Watanabe,et al.  Chronic gastritis in Japanese with reference to high incidence of gastric carcinoma. , 1971, Journal of the National Cancer Institute.

[14]  A. Gasparov.  [Malignant tumors of the gastrointestinal tract]. , 1957, Medicinski glasnik.

[15]  P. Isaacson.  Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) , 2001 .

[16]  W. Weir,et al.  Campylobacter-like organisms and gastritis in Africa. , 1988, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[17]  P. Hiza.  Malignant disease in Tanzania. , 1976, East African medical journal.