Publication: Helicobacter pylori infection, glandular atrophy, intestinal metaplasia and topography of chronic active gastritis in the Nepalese and Japanese population: The age, gender and endoscopic diagnosis matched study
Date
2007
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Background: The incidence and mortality from gastric cancer is high in Japanese but extremely low in
Thailand. It is different among Asian countries. The aim of this study is to investigate the difference of peptic
ulcer disease, glandular atrophy, intestinal metaplasia and topography of chronic active gastritis between the
Nepalese and Japanese population.
Materials and methods: Nepalese patients were paired with Japanese patients by age, gender and
endoscopic diagnosis in order to compare the prevalence of H. pylori infection (N=309) and the difference of
H. pylori related peptic ulcer disease (N=48). Glandular atrophy and intestinal metaplasia scores were also
compared between the Nepalese and Japanese population in H. pylori positive cases (N=152) and negative
cases (N=145) using paired cases by age, gender and endoscopic diagnosis. Paired H. pylori-positive
Nepalese and Japanese population were also used to compare the ratio of corpus gastritis to antrum gastritis
(C/A ratio) (N=152).
Results: Among peptic ulcer diseases, gastric ulcer was frequent in Japanese and duodenal ulcer was
frequent in Nepalese. The prevalence of H. pylori infection in the Nepalese and Japanese population were
similar. Glandular atrophy and intestinal metaplasia scores in the H. pylori positive Japanese were
significantly higher than those of Nepalese in all positions according to triple site biopsy. Furthermore, there
were significant differences in glandular atrophy and intestinal metaplasia scores between in the H.
pylori-negative Nepalese and Japanese population except intestinal metaplasia score in the greater curvature
of the upper corpus. Japanese C/A ratio was significantly higher than that of Nepalese. Corpus predominant
gastritis (C/A ratio>1.00) was characteristic in the elderly Japanese. Nepalese was antrum predominant (C/A
ratio<1.00) in every age group.
Conclusions. Gastric ulcer was a common disease in Japanese, in contrast duodenal ulcer was common in
Nepalese. H. pylori infected Japanese patients showed severe atrophic and metaplastic gastritis in comparison
with Nepalese. These results may be associated with the high incidence of gastric cancer in Japanese. Corpus
predominant gastritis was found in the elderly Japanese and antrum predominant gastritis was found in every
age Nepalese.
Key words: H. pylori, atrophy, metaplasia, corpus-predominant gastritis, Nepal
Description
Matsuhisa T 1 , Miki M 2 , Yamada N 3 , Sharma SK 4 , Shrestha BM 5
1 Department of Gastrointestinal Endoscopy, Tama-Nagayama Hospital, Nippon Medical School, 1-7-1, Nagayama, Tama City, Tokyo 206-8512, Japan, 2Department of Surgery I, 3 Department of Pathology II, Nippon Medical School, 1-1-5 Sendagi, Bunkyo Ku, Tokyo 113-0022, Japan, 4 Department of Surgery,
5 Department of Anaesthesia, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal