[Campylobacter pylori in gastro-duodenal diseases, with special reference to endoscopic diagnosis, histological inflammatory grading, and intestinal metaplasia].

To investigate the prevalence of Campylobacter pylori (CP) and its association with histological inflammatory grading and intestinal metaplasia, biopsies were carried out in 388 patients with gastro-duodenal diseases from 2 sites in the stomach (body and antrum). In each case, 3 biopsy specimens were taken from each site for culture, acridine orange stain and urease test. CP was detected in 55% of 22 endoscopically normal patients, in 47% of 17 gastric cancer patients, in 73% of 205 gastritis patients in 91% of 99 gastric ulcer patients and in 100% of 45 duodenal ulcer patients. In gastric ulcer and duodenal ulcer patients, CP detection rate was significantly higher than in endoscopically normal patients (p less than 0.01). There was no difference in CP detection rate irrespective of ulcer stage (active, healing or scar). According to the histological gradings of inflammation (Warren's criteria), CP was detected in only 3% in grade 0-I, 20% in grade II and 83% in grade III. It was found that a close association between CP and histological gastritis with polymorphonuclear leukocytes infiltration exists (p less than 0.001). In a few cases, CP was found even in the areas of intestinal metaplasia. But the number of CP in the areas of intestinal metaplasia were fewer than in the areas of surrounding inflamed gastric mucosa. In most cases, CP was not seen in the areas of intestinal metaplasia, but was found in the areas of surrounding inflamed gastric mucosa in the same biopsy specimen.