The particularity of Helicobacter pylori chronic gastritis in the west center of Tunisia

##plugins.themes.academic_pro.article.sidebar##

Published Mar 1, 2010
Download
pdf
Vol. 88 No. 3 (2010): Issue Mar 2010

##plugins.themes.academic_pro.article.main##

Rafik Jmaa
Belgacem Aissaoui
Lamia Golli
Ali Jmaa
jaouad Al Qaddi
Aida Ben Slama
Sonia Ziadi
Salem Ajmi

Abstract

Background : The Helicobacter pylori (HP) is strongly associated with chronic gastritis.
The aim of our study was to determine prevalence of the HP chronic gastritis in the west center of Tunisia and to clarify the clinical and the histological particularitiesof this infection.
Methods: it is a prospectif study carried out from September 2002 to July 2005 and had included 352 patients. All the patients had an upper endoscopy in which five gastric biopsies were taken for a histological study. The biopsy specimens were fixed in 10% buffered formol and then included in paraffin. The specimens were cut at 4 μm and stained with Hematoxyline Eosine, modified Giemsa and Alcian bleu SAP. The histological examination revealed HP specimens, the
lymphoplasmocytic infiltration, the gastritis activity, the gastric atrophy and the intestinal metaplasia according to Sydney system.
Results: They were 162 men and 190 women,with a mean age of 48,3 years. The erythematous antral gastritis was the most frequent at endoscopy (26, 7%) The prevalence of HP chronic gastritis was 89 % in patients with endoscopic lesions The activity of the gastritis was 89,7 % in the antrum and 52,2 % in the fundus. The activity mean score in the antrum was 2, 1,8 and 0,3 respectively in the case of duodenal ulcer and gastric adenocarcinoma vs 0,68, 1,1 and 0,16 in
gastric fundus. The prevalence of gastric atrophy was 35%. The atrophy was found in the antrum in 98% of cases. The prevalence of intestinal metaplasic was 11%.
Conclusion: the HP chronic gastritis is very frequent in the west center of Tunisia. Its prevalence is found elevated since the adolescence. It predominate the gastric antrum. It is often associated with a duodenal ulcer rather than gastric cancer.

Keywords:

Helicobacter pylori, Histology, Chronic Gastritis

##plugins.themes.academic_pro.article.details##

References

  1. Parsonnet J. Helicobacter pylori in stomach: a paradox unmasked. N Eng J Med 1996; 335: 278-80.
  2. Dixon.MF, Genta.RM, Yardley.JH, Correa.P . Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996; 20: 1161-81.
  3. Conférence de consensus Helicobacter pylori - révision 99. Conclusions et recommandations révisées du groupe de travail. Gastroenterol Clin Biol 1999; 23: c95-c104.
  4. N. Djemel.N, Khammasi.S , Bouzaidi.S. Prévalence de l'hélicobacter pylori en Tunisie chez des témoins asymptomatiques et au cours de la dyspepsie non ulcéreuse et de l'ulcère duodénal. Etude prospective de 183 cas. Tun Med 1995; 73: 373-7.
  5. Ben Ammar.A, Cheikh.I, Kchaou.M . Prevalence of helicobater pylori in normal or asypmtomatic patients. Tunis Med 2003; 81: 200-4.
  6. Bouali.R, Ben Moussa.M , Jemaa.A, et al. High prevalence of helicobacter pylori infection in Tunisia. The American Journal of Gastroenterology 2003; 98 (Suppl. 1): S40.
  7. Megraud.F, Brassens-Rabbé.MP, Denis.F. Seroepidemiology of campylobacter pylori in various populations. J clin Microbilol 1989; 27: 1870-3.
  8. Fendri.C . Prévalence actuelle de l'infection à hélicobacter pylori et tendances évolutives dans le pays de Maghreb. La lettre de l'infectiologue 2000; 15 (suppl. 3): 24-7.
  9. Bani- Hani.KE , Hammuori.SM. Prevalence of helicobater pylori in Northern Jordan. Endoscopy based study. Saudi Med J 2001; 22: 843-7.
  10. Mbengue.M, Diouf.ML, Dangou.JM. Fréquence de l'infection à hélicobacter pylori chez les sujets symptomatiques au Senégal. Med Trop 1997; 57: 256-8.
  11. Lahaie.RG , Lahaie.MA, Bovin.M. Prévalence actuelle de l'infection à hélicobacter pylori et tendances évolutives en Amérique du Nord. La lettre de l'infectiologue 2000; 15 (supp. 3): 18-22.
  12. Graham.DY, Adam.E. Epidemiology of helicobacter pylori in a asymptomatic population in the United States. Gastroenterology 1991; 100: 1459-501.
  13. Broute.N. Prévalence actuelle de l'infection à hélicobacter pylori et tendance évolutive en Europe. La lettre de l'infectiologue 2000; 15 (suppl. 3): 28-9.
  14. Rectorzchek.M, Weeks.D,.Sachs.G. Influence of PH on metabolism and urease activity of H. pylori. Gastroenterology 1998; 115: 628- 41.
  15. Courillon- Mallet.A. Infection à helicobacter pylori et sécrétion acide gastrique. Gastroenterol Clin Biol 1997; 21: 139-46.
  16. Bretagne.JF, Hersabach.D. Helicobacter, achlorhydrie et atrophie gastrique: quel mélange à trois ? Gastroenterol Clin Biol 1997; 21: 117-23.
  17. Asaka.M, Sugiyama.T, Nobuta.A, Kato.M, Takeda.H,Graham.DY Atrophic gastritis and intestinal metaplasia in Japan: results of a large multicenter study. Helicobacter 2001;6:294-9.
  18. You.WC, Zhang.L, Gail.MH, Li.JY. Precancerous lesions in two countries of China with contrasting gastric cancer risk. Journal of Clinical Pathology 2004; 57: 37-42.
  19. Matsuhisa.TM, Yamada.NY, Kato.SK, Matsukura.NM. Helicobacter pylori infection, mucosal atrophy and intestinal R.Jmaa - Gastrite chronique à Hélicobacter pylori metaplasia in Asian populations: a comparative study in age-, gender- and endoscopic diagnosis-matched subjects. Helicobacter 2003 Feb; 8: 29-35
  20. Rubio.CA, Jonasson.J, Nesi.G . Owen Extensive intestinal metaplasia in gastric carcinoma and in other lesions requiring surgery. A study of 3421 gastrectomy specimens from dwellers of the Atlantic and Pacific basins. Journal of Clinical Pathology 2005; 58: 1271-7.
  21. Leodolter.A, Ebert.MP, Peitz U. Prevalence of H pylori associated high risk gastritis for development of gastric cancer in patients with normal endoscopic findings. World J Gastroenterol 2006; 12: 5509- 12.
  22. Vieth.M, Stolte.M. Elevated risk for gastric adenocarcinoma can be predicted from histomorphology. World J Gastroentrol 2006; 12 (38): 6109-14.
  23. Brian Fennetry.M. Gastric intestinal metaplasia on routine endoscopic biopsy. Gastroenterology 2003; 125: 586-90.