Helicobacter pylori infection in patients with gastric carcinoma in biopsy and surgical resection specimens

BACKGROUND. The discrepancy between the high seropositivity for Helicobacter pylori (H. pylori) and the low diagnostic yield of H. pylori organism in gastric biopsies of patients with gastric carcinoma has yet to be clarified. The present study attempted to clarify this controversial point by performing a comparative evaluation between the detection rate of H. pylori in biopsy and in surgical specimens. METHODS. The presence of H. pylori in biopsy samples from 50 patients with gastric carcinoma and 50 age-matched controls was evaluated histologically. Six histologic sections were obtained from gastric noncancerous areas and the presence of H. pylori was evaluated in those H. pylori negative patients who underwent gastrectomy. RESULTS. H. pylori was positive in 35 of 50 controls (70%). In biopsy samples, H. pylori was detected in 29 of 37 patients (78.4%) with early gastric carcinoma, 7 of 13 (53.8%) with advanced carcinoma, 16 of 23 (69.5%) with intestinal type of gastric carcinoma, and 20 of 27 (74.1%) with diffuse type of carcinoma. Studies carried out in gastrectomy specimens increased the diagnostic yield of H. pylori to 33 (89.2%), 12 (92.3%), 19 (82.6%), and 26 (96.3%) in patients with early, advanced, intestinal, and diffuse types of gastric carcinoma, respectively. Overall, H. pylori was positive in 36 biopsy specimens (72%) and 45 gastrectomy specimens (90%). Namely, the detection of H. pylori infection was significantly higher in patients with gastric carcinoma using gastrectomy specimens than in patients with gastric carcinoma using biopsy specimens only (P < 0.05). CONCLUSIONS. These results indicate that the actual prevalence of H. pylori in patients with gastric carcinoma is considerably higher than that previously reported.