[Is gastric carditis associated with antral gastritis in patients with non-ulcer dyspesia and Helicobatcer pylori infection?].

UNLABELLED: Helicobacter pylori is the most frequent cause of antral gastritis type B. Little is known about the affection of the gastric cardia by inflammation associated with H. pylori infection.

OBJECTIVE: Assess the status of morphological changes of the cardia in the presence of H. pylori infection in patients with non-ulcer dyspesia.

METHODS AND PATIENTS: 251 consecutive dyspeptic patients with H.pylori infection were subjected to endoscopic examination of the upper part of the gastrointestinal tract. Six biopsies were taken (2 antrum, 2, corpus, 2 cardia) for histological (HaE) and microscopic (Giemsa) status, scored according to the Sydney classification.

RESULTS: Chronic inflammation and its activity reached similar values in the antrum and cardia, the difference was not statistically significant (p>0.05). The findings of H.pylori and intestinal metaplasia (IM) were higher in the antrum than in the cardia (p<0.05) similarly as atrophy and hyperplasia of lymphatic tissue (p<0.01). Significantly higher values were recorded in chronic inflammation, its activity and number of HP in the antrum (p<0.001). The same applies to atrophy, IM, lymphoid follicles (p<0.01), dysplasia and hyperplasia of lymphatic tissue (p<0.05). Conversely chronic inflammation, activity and HP in the cardia were significantly higher than in the corpus (p<0.001), similarly IM and lymphoid follicles (p<0.01), atrophy and dysplasia (p<0.05).

CONCLUSION: The incidence of carditis and antral gastritis associated with H.pylori infection was equally expressed and reached a higher score than corporal gastritis. Inflammatory infiltration of the cardia may play a crucial role in the pathogenesis of non-ulcer dyspepsia.