Oluwasola A O, Ogunbiyi J O
Department of Pahology, University College Hospital, Ibadan, Nigeria.
Niger J Med. 2004 Oct-Dec;13(4):372-8.
Fibreoptic endoscopic gastric biopsy, has revealed that chronic gastritis is not only of a complex aetiological background, but also varied topographical distribution and other clinico-pathological associations. By far, the most important aetiologic association of chronic gastritis is chronic infection by the bacillus Helicobacter pylori. This study aims to highlight some of the histopathological associations between this bacterium and chronic gastritis.
We reviewed all endoscopic gastric biopsies with a histological diagnosis of chronic gastritis, with available case records and archival tissues over an 18 year period, to determine association between the various pathological features of chronic gastritis present and the presence of H. pylori infection.
Eighty-five cases with histological diagnosis of chronic gastritis fulfilled the inclusion criteria, and Helicobacter pylori infection was found in 22.4% of them. Most patients (83.1%) with chronic gastritis had moderate to severe grades of inflammation, and most (84.2%) of the infection involved the gastric antrum. Pangastritis was uncommon (10.5%). A greater proportion of the antral biopsies (87.5%) showed moderate to severe grades of chronic gastritis as compared with 16.7% of corporal biopsies. There was an early age of acquisition of infection, starting at the second decade of life, with a peak in the 6th decade. The frequencies of atrophic gastritis and intestinal metaplasia seen complicating chronic gastritis were 16.7% and 9.4% respectively.
The study shows that Helicobacter pylori infection is associated mainly with moderate to severe chronic gastritis in Nigerians. This study confirms the antral predilection of H. pylori infection, and the finding of an antral preponderance for chronic gastritis partly explains the relatively more frequent occurrence of duodenal ulcers in Nigerians as compared to gastric ulcers. Furthermore, the finding of a low prevalence of atrophic gastritis and intestinal metaplasia, as well as the rarity of pangastritis in our patients probably explains in part, the low incidence of gastric cancer in Nigeria.
纤维内镜下胃活检显示，慢性胃炎不仅病因复杂，而且病变部位分布多样，还存在其他临床病理关联。到目前为止，慢性胃炎最重要的病因关联是幽门螺杆菌慢性感染。本研究旨在强调这种细菌与慢性胃炎之间的一些组织病理学关联。
我们回顾了18年间所有经组织学诊断为慢性胃炎的内镜下胃活检病例，以及可用的病例记录和存档组织，以确定慢性胃炎的各种病理特征与幽门螺杆菌感染之间的关联。
85例经组织学诊断为慢性胃炎的病例符合纳入标准，其中22.4%发现有幽门螺杆菌感染。大多数慢性胃炎患者（83.1%）有中度至重度炎症，且大多数感染（84.2%）累及胃窦。全胃炎并不常见（10.5%）。与胃体活检的16.7%相比，更大比例的胃窦活检（87.5%）显示为中度至重度慢性胃炎。感染多在生命的第二个十年开始，在第六个十年达到高峰。慢性胃炎并发萎缩性胃炎和肠化生的频率分别为16.7%和9.4%。
该研究表明，在尼日利亚人当中，幽门螺杆菌感染主要与中度至重度慢性胃炎有关。本研究证实了幽门螺杆菌感染对胃窦的偏好，胃窦部慢性胃炎占优势这一发现部分解释了尼日利亚人十二指肠溃疡比胃溃疡相对更频繁发生的原因。此外，我们的患者中萎缩性胃炎和肠化生的低患病率以及全胃炎的罕见情况可能部分解释了尼日利亚胃癌发病率较低的原因。
