A Demirel, S Oncel, M Çaydere, A Dogan, H Usten, A Ongoren
endoscopy, gastrectomy, gastroenterology, helicobacter pylori, medicine
A Demirel, S Oncel, M Çaydere, A Dogan, H Usten, A Ongoren. Helicobacter Pylori Infection In Gastrectomy Specimens. The Internet Journal of Gastroenterology. 1999 Volume 1 Number 1.
The gastrectomy specimens of 46 patients were re-examined microscopically.
Twenty-eight of the 31 patients with malignant gastric tumors had gastric carcinoma. Seven (25%) of these had H. pylori infection.
Nine patients had gastric ulcer and six had duodenal ulcer. The prevalence of H. pylori infection in this group (of benign diseases) was 47% (7/15).
The prevalence of H. pylori infection is lower than expected in H. pylori-related gastric diseases. The difference between the prevalences of H. pylori infection in benign and malignant gastric diseases was not statistically significant.
Our conclusions are that diffuse type gastric garcinoma is more correlated with H. pylori infection than the intestinal-type and that the diffuse-type gastric carcinoma tends to occur closer to pylorus than does the intestinal-type. This differs from those of the reviewed literature. We therefore suggest that H. pylori-related diseases in Turkey may have extraordinary features and that more extensive studies be carried out.
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After having been isolated by Marshall and Warren in 1982 and shown to be associated with duodenal ulceration,
We investigated the characteristics of benign and malignant diseases of the stomach, that are known to be associated with
MATERIALS AND METHODS
We retrospectively examined the surgical specimens of 31 patients with malignant gastric tumors (7 female + 24 male) and 15 patients with peptic ulcer disease (4 female + 11 male), who had been hospitalized in the Second Department of General Surgery, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey between January 1st, 1993 and August 1st, 1998 and had been treated with gastrectomy (15 total and 31 partial).
These specimens were fixed in 10% formaline solution for 48 hours and embedded in paraffin blocks. This material was cut into 6 (m-thick sections, incubated in 50 (C for 12 hours, deparaffinized with xylol, dehydrated with ethyl alcohol and hydrated with deionized water and stained with hematoxylin-eosin.
All specimens were re-examined for the presence of
Malignant tumors of the stomach
Of the 31 patients who had a malignant tumor of the stomach, 28 had gastric carcinoma, two had gastric sarcoma and one had gastric lymphoma.
Of the sarcomas, one was in the corpus and the other sarcoma demonstrated extensive involvement. The lymphoma was located in the corpus. The locations of gastric carcinomas are shown in (TABLE II).
Of the gastric carcinomas, 14 (50%) were intestinal and 14 (50%) were diffuse. Clinical staging of the patients’ tumors were performed according to TNM classification (6) as shown in (TABLE 3).
Benign Diseases of the Stomach
The patients with benign diseases of the stomach are shown in TABLE IV. Two of these patients had gastric polyps.
Seven patients (47%) with a benign disease of the stomach had
According to Sydney classification, the grade of
Statistical analysis of this study was performed using SPSS for Windows 7.5 software. The following correlations were found although their Spearman coefficient are weak:
The closer the gastric carcinoma is located to the pylorus, the more likely it presents as diffuse histological type. As the clinical stage increases, the chances that the gastric carcinoma is diffuse also increases.
The prevalence of
According to Fischer’s exact chi-square test, there is no difference in the prevalence of
Investigators have reported different prevalence rates of
The stages of most of the patients were above stage II; for this reason the tumor tissue may have provided a hostile environment for the microorganism. If this is the case, the examination of the areas that are remote from the tumor might reveal H. pylori infection.
The relatively small number of patients enrolled in our study makes it difficult to obtain more reliable data.
Although in many studies it is concluded that intestinal-type gastric carcinoma had a stronger association with
Acoording to the results of our study,
In contrast to the reviewed literature, diffuse-type gastric carcinoma tends to arise closer to the pylorus instead of fundus.
The association between
This study reveals that in Turkey some characteristics of the associations of gastric diseases with
The authors would like to thank Dr. Ilter ETIKAN for statistics and Associate Dozent Dr. Onder BOZDOGAN for comments.