Assessment of Cell Proliferation in Helicobacter pylori associated gastric epithelial diseases

Background: Alterations in cell proliferation and apoptosis as a result of Helicobacter Pylori infection can contribute to carcinogenesis. This study was planned to assess cellular proliferation during chronic active gastritis with or without H. Pylori , atrophy, intestinal metaplasia, dysplasia and carcinoma. Effect of H. Pylori eradication on cell proliferation was also studied. Methods: Ki67 immunostaining was done to calculate proliferative index (PI) in H. pylori associated gastric diseases. Gastric biopsies of 160 patients with dyspepsia were selected comprising of 20 cases each of following groups 1) Normal control 2) H . pylori positive chronic active gastritis before and after treatment 3) H. pylori negative chronic active gastritis 4) Atrophy 5 ) Intestinal metaplasia 6) Dysplasia 7) Gastric adenocarcinoma Result: There was increased proliferative index (PI) in H. pylori positive and negative chronic active gastritis as compared to normal controls. However, the PI in H. pylori positive chronic active gastritis was significantly higher than that of H. pylori negative chronic active gastritis. Increased proliferation was persistent in atrophy, intestinal metaplasia, dysplasia and carcinoma. There was significant increase in PI in foveolar regions in chronic active gastritis, intestinal metaplasia and dysplasia . After H. pylori eradication, there was marked reduction in PI. Conclusion: H. pylori infection results in increased gastric epithelial cell proliferation which persists in the premalignant stages of atrophy, intestinal metaplasia, dysplasia and carcinoma. Presence of H. pylori augments proliferation resulting from inflammation and eradication of H. pylori reduces proliferation. This increased proliferation may be one of the mechanism of H. pylori associated carcinogenesis. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}