PREVALENCE OF HELICOBACTER PYLORI INFECTION IN 160 PATIENTS WITH BARRETT’S OESOPHAGUS OR BARRETT’S ADENOCARCINOMA

Background: The role of Helicobacter pylori infection in the development of Barrett’s oesophagus and its complications is uncertain. The aim of the present study was to determine the importance of H. pylori infection in this disease by comparing the frequency of oesophageal and gastric H. pylori inf...

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Veröffentlicht in:Australian and New Zealand Journal of Surgery 2000-01, Vol.70 (1), p.26-33
Hauptverfasser: Lord, Reginald V. N., Frommer, Donald J., Inder, Stephanie, Tran, Dinh, Ward, Robyn L.
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container_start_page 26
container_title Australian and New Zealand Journal of Surgery
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creator Lord, Reginald V. N.
Frommer, Donald J.
Inder, Stephanie
Tran, Dinh
Ward, Robyn L.
description Background: The role of Helicobacter pylori infection in the development of Barrett’s oesophagus and its complications is uncertain. The aim of the present study was to determine the importance of H. pylori infection in this disease by comparing the frequency of oesophageal and gastric H. pylori infection in a group of patients with Barrett’s oesophagus or adenocarcinoma, with the frequency of infection in a control group without Barrett’s disease. Methods: The study group included 160 patients (123 male, 37 female; mean age: 61.2 years) who were classified (according to the highest grade pathological lesion in the oesophagus) as having Barrett’s intestinal metaplasia (IM; 88 patients), Barrett’s oesophagus with low‐grade dysplasia (LGD; 28 patients), high‐grade dysplasia (HGD; five patients), Barrett’s indefinite for dysplasia (n = 4), and Barrett’s adenocarcinoma (33 patients). A total of 91 of these patients had gastric antral specimens available for study. The control group consisted of 214 consecutive, prospectively enrolled symptomatic patients (122 male, 92 female; mean age: 57.2 years) who underwent upper gastrointestinal endoscopy and in whom Barrett’s oesophagus or Barrett’s adenocarcinoma was not found. A modified Warthin–Starry method was used to detect H. pylori infection. Results: Oesophageal H. pylori infection was found in eight of 160 (5%) patients with Barrett’s oesophagus or Barrett’s adenocarcinoma. Helicobacter pylori organisms in the oesophagus were found only on non‐intestinalized cardiac or oxyntocardiac mucosa. All patients with oesophageal H. pylori infection and an antral biopsy available for study had antral H. pylori infection. Gastric antral H. pylori infection was significantly less prevalent in patients in the Barrett’s study group (15/91, 16.5%) than in the non‐Barrett’s control group (67/214, 31.3%; Fisher’s exact test, P = 0.01). Patients from the control group with an endoscopic diagnosis of duodenal ulcer, gastric ulcer, gastritis, or duodenitis had a significantly higher prevalence of infection compared with the Barrett’s group, but there was no difference in the infection prevalence in patients in the Barrett’s group and patients with reflux oesophagitis, hiatal hernia, no endoscopic abnormality, or any other diagnosis. Conclusions: Oesophageal H. pylori infection is uncommon in patients with Barrett’s IM, dysplasia, or adenocarcinoma, and may be restricted to non‐intestinalized columnar epithelium. Gastric H. pylori
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N. ; Frommer, Donald J. ; Inder, Stephanie ; Tran, Dinh ; Ward, Robyn L.</creator><creatorcontrib>Lord, Reginald V. N. ; Frommer, Donald J. ; Inder, Stephanie ; Tran, Dinh ; Ward, Robyn L.</creatorcontrib><description>Background: The role of Helicobacter pylori infection in the development of Barrett’s oesophagus and its complications is uncertain. The aim of the present study was to determine the importance of H. pylori infection in this disease by comparing the frequency of oesophageal and gastric H. pylori infection in a group of patients with Barrett’s oesophagus or adenocarcinoma, with the frequency of infection in a control group without Barrett’s disease. Methods: The study group included 160 patients (123 male, 37 female; mean age: 61.2 years) who were classified (according to the highest grade pathological lesion in the oesophagus) as having Barrett’s intestinal metaplasia (IM; 88 patients), Barrett’s oesophagus with low‐grade dysplasia (LGD; 28 patients), high‐grade dysplasia (HGD; five patients), Barrett’s indefinite for dysplasia (n = 4), and Barrett’s adenocarcinoma (33 patients). A total of 91 of these patients had gastric antral specimens available for study. The control group consisted of 214 consecutive, prospectively enrolled symptomatic patients (122 male, 92 female; mean age: 57.2 years) who underwent upper gastrointestinal endoscopy and in whom Barrett’s oesophagus or Barrett’s adenocarcinoma was not found. A modified Warthin–Starry method was used to detect H. pylori infection. Results: Oesophageal H. pylori infection was found in eight of 160 (5%) patients with Barrett’s oesophagus or Barrett’s adenocarcinoma. Helicobacter pylori organisms in the oesophagus were found only on non‐intestinalized cardiac or oxyntocardiac mucosa. All patients with oesophageal H. pylori infection and an antral biopsy available for study had antral H. pylori infection. Gastric antral H. pylori infection was significantly less prevalent in patients in the Barrett’s study group (15/91, 16.5%) than in the non‐Barrett’s control group (67/214, 31.3%; Fisher’s exact test, P = 0.01). Patients from the control group with an endoscopic diagnosis of duodenal ulcer, gastric ulcer, gastritis, or duodenitis had a significantly higher prevalence of infection compared with the Barrett’s group, but there was no difference in the infection prevalence in patients in the Barrett’s group and patients with reflux oesophagitis, hiatal hernia, no endoscopic abnormality, or any other diagnosis. Conclusions: Oesophageal H. pylori infection is uncommon in patients with Barrett’s IM, dysplasia, or adenocarcinoma, and may be restricted to non‐intestinalized columnar epithelium. Gastric H. pylori infection may have a protective effect for the development of Barrett’s oesophagus.</description><identifier>ISSN: 0004-8682</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1046/j.1440-1622.2000.01737.x</identifier><identifier>PMID: 10696939</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Science Pty</publisher><subject>adenocarcinoma ; Adenocarcinoma - epidemiology ; Adenocarcinoma - microbiology ; Aged ; Barrett Esophagus - epidemiology ; Barrett Esophagus - microbiology ; Barrett’s oesophagus ; Esophageal Neoplasms - epidemiology ; Esophageal Neoplasms - microbiology ; Female ; Gastric Mucosa - microbiology ; Gastric Mucosa - pathology ; Gastroesophageal Reflux - epidemiology ; Gastroesophageal Reflux - microbiology ; gastro‐oesophageal reflux disease ; Helicobacter Infections - epidemiology ; Helicobacter pylori ; Humans ; Male ; Metaplasia - microbiology ; Middle Aged ; oesophageal adenocarcinoma ; oesophagitis ; oesophagus ; Prevalence</subject><ispartof>Australian and New Zealand Journal of Surgery, 2000-01, Vol.70 (1), p.26-33</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3107-58e4c6ba4c127d2ce21161e20e489053efc1a32f0fbbb8dc32eeabcb138b4023</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1440-1622.2000.01737.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1440-1622.2000.01737.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10696939$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lord, Reginald V. N.</creatorcontrib><creatorcontrib>Frommer, Donald J.</creatorcontrib><creatorcontrib>Inder, Stephanie</creatorcontrib><creatorcontrib>Tran, Dinh</creatorcontrib><creatorcontrib>Ward, Robyn L.</creatorcontrib><title>PREVALENCE OF HELICOBACTER PYLORI INFECTION IN 160 PATIENTS WITH BARRETT’S OESOPHAGUS OR BARRETT’S ADENOCARCINOMA</title><title>Australian and New Zealand Journal of Surgery</title><addtitle>Aust N Z J Surg</addtitle><description>Background: The role of Helicobacter pylori infection in the development of Barrett’s oesophagus and its complications is uncertain. The aim of the present study was to determine the importance of H. pylori infection in this disease by comparing the frequency of oesophageal and gastric H. pylori infection in a group of patients with Barrett’s oesophagus or adenocarcinoma, with the frequency of infection in a control group without Barrett’s disease. Methods: The study group included 160 patients (123 male, 37 female; mean age: 61.2 years) who were classified (according to the highest grade pathological lesion in the oesophagus) as having Barrett’s intestinal metaplasia (IM; 88 patients), Barrett’s oesophagus with low‐grade dysplasia (LGD; 28 patients), high‐grade dysplasia (HGD; five patients), Barrett’s indefinite for dysplasia (n = 4), and Barrett’s adenocarcinoma (33 patients). A total of 91 of these patients had gastric antral specimens available for study. The control group consisted of 214 consecutive, prospectively enrolled symptomatic patients (122 male, 92 female; mean age: 57.2 years) who underwent upper gastrointestinal endoscopy and in whom Barrett’s oesophagus or Barrett’s adenocarcinoma was not found. A modified Warthin–Starry method was used to detect H. pylori infection. Results: Oesophageal H. pylori infection was found in eight of 160 (5%) patients with Barrett’s oesophagus or Barrett’s adenocarcinoma. Helicobacter pylori organisms in the oesophagus were found only on non‐intestinalized cardiac or oxyntocardiac mucosa. All patients with oesophageal H. pylori infection and an antral biopsy available for study had antral H. pylori infection. Gastric antral H. pylori infection was significantly less prevalent in patients in the Barrett’s study group (15/91, 16.5%) than in the non‐Barrett’s control group (67/214, 31.3%; Fisher’s exact test, P = 0.01). Patients from the control group with an endoscopic diagnosis of duodenal ulcer, gastric ulcer, gastritis, or duodenitis had a significantly higher prevalence of infection compared with the Barrett’s group, but there was no difference in the infection prevalence in patients in the Barrett’s group and patients with reflux oesophagitis, hiatal hernia, no endoscopic abnormality, or any other diagnosis. Conclusions: Oesophageal H. pylori infection is uncommon in patients with Barrett’s IM, dysplasia, or adenocarcinoma, and may be restricted to non‐intestinalized columnar epithelium. Gastric H. pylori infection may have a protective effect for the development of Barrett’s oesophagus.</description><subject>adenocarcinoma</subject><subject>Adenocarcinoma - epidemiology</subject><subject>Adenocarcinoma - microbiology</subject><subject>Aged</subject><subject>Barrett Esophagus - epidemiology</subject><subject>Barrett Esophagus - microbiology</subject><subject>Barrett’s oesophagus</subject><subject>Esophageal Neoplasms - epidemiology</subject><subject>Esophageal Neoplasms - microbiology</subject><subject>Female</subject><subject>Gastric Mucosa - microbiology</subject><subject>Gastric Mucosa - pathology</subject><subject>Gastroesophageal Reflux - epidemiology</subject><subject>Gastroesophageal Reflux - microbiology</subject><subject>gastro‐oesophageal reflux disease</subject><subject>Helicobacter Infections - epidemiology</subject><subject>Helicobacter pylori</subject><subject>Humans</subject><subject>Male</subject><subject>Metaplasia - microbiology</subject><subject>Middle Aged</subject><subject>oesophageal adenocarcinoma</subject><subject>oesophagitis</subject><subject>oesophagus</subject><subject>Prevalence</subject><issn>0004-8682</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1u2zAQhYmiReL8XKHgqjspHJKmqEUXjELHAlTRkNkWXRESTQE27DqRYiTZ5Rq9Xk9Sqc6i3WU1b_DemwE-hDCQGAgXV5sYOCcRCEpjSgiJCSQsiZ_eoclgTCMKafIeTQaHR1JIeorO-n4zrkLKE3QKRKQiZekEHRaV_qYKXWYamxme6yLPzLXKrK7w4kdhqhzn5UxnNjfloDAIghfK5rq0S_w9t3N8rapKW_v75dcSG700i7m6_TrI6j9H3ejSZKrK8tJ8URfoQ1tv-3D5Os-RnWmbzaPC3OaZKiLPgCTRVAbuRVNzDzRZUR8ogIBASeAyJVMWWg81oy1pm6aRK89oCHXjG2Cy4YSyc_TpePau298fQv_gduveh-22_hn2h94lJBWcChiC8hj03b7vu9C6u269q7tnB8SNxN3GjcTdSNyNxN1f4u5pqH58_XFodmH1T_GIeAh8PgYe19vw_ObDTpXLUbE_nPSH4g</recordid><startdate>200001</startdate><enddate>200001</enddate><creator>Lord, Reginald V. N.</creator><creator>Frommer, Donald J.</creator><creator>Inder, Stephanie</creator><creator>Tran, Dinh</creator><creator>Ward, Robyn L.</creator><general>Blackwell Science Pty</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200001</creationdate><title>PREVALENCE OF HELICOBACTER PYLORI INFECTION IN 160 PATIENTS WITH BARRETT’S OESOPHAGUS OR BARRETT’S ADENOCARCINOMA</title><author>Lord, Reginald V. N. ; Frommer, Donald J. ; Inder, Stephanie ; Tran, Dinh ; Ward, Robyn L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3107-58e4c6ba4c127d2ce21161e20e489053efc1a32f0fbbb8dc32eeabcb138b4023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>adenocarcinoma</topic><topic>Adenocarcinoma - epidemiology</topic><topic>Adenocarcinoma - microbiology</topic><topic>Aged</topic><topic>Barrett Esophagus - epidemiology</topic><topic>Barrett Esophagus - microbiology</topic><topic>Barrett’s oesophagus</topic><topic>Esophageal Neoplasms - epidemiology</topic><topic>Esophageal Neoplasms - microbiology</topic><topic>Female</topic><topic>Gastric Mucosa - microbiology</topic><topic>Gastric Mucosa - pathology</topic><topic>Gastroesophageal Reflux - epidemiology</topic><topic>Gastroesophageal Reflux - microbiology</topic><topic>gastro‐oesophageal reflux disease</topic><topic>Helicobacter Infections - epidemiology</topic><topic>Helicobacter pylori</topic><topic>Humans</topic><topic>Male</topic><topic>Metaplasia - microbiology</topic><topic>Middle Aged</topic><topic>oesophageal adenocarcinoma</topic><topic>oesophagitis</topic><topic>oesophagus</topic><topic>Prevalence</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lord, Reginald V. N.</creatorcontrib><creatorcontrib>Frommer, Donald J.</creatorcontrib><creatorcontrib>Inder, Stephanie</creatorcontrib><creatorcontrib>Tran, Dinh</creatorcontrib><creatorcontrib>Ward, Robyn L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Australian and New Zealand Journal of Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lord, Reginald V. N.</au><au>Frommer, Donald J.</au><au>Inder, Stephanie</au><au>Tran, Dinh</au><au>Ward, Robyn L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>PREVALENCE OF HELICOBACTER PYLORI INFECTION IN 160 PATIENTS WITH BARRETT’S OESOPHAGUS OR BARRETT’S ADENOCARCINOMA</atitle><jtitle>Australian and New Zealand Journal of Surgery</jtitle><addtitle>Aust N Z J Surg</addtitle><date>2000-01</date><risdate>2000</risdate><volume>70</volume><issue>1</issue><spage>26</spage><epage>33</epage><pages>26-33</pages><issn>0004-8682</issn><eissn>1445-2197</eissn><abstract>Background: The role of Helicobacter pylori infection in the development of Barrett’s oesophagus and its complications is uncertain. The aim of the present study was to determine the importance of H. pylori infection in this disease by comparing the frequency of oesophageal and gastric H. pylori infection in a group of patients with Barrett’s oesophagus or adenocarcinoma, with the frequency of infection in a control group without Barrett’s disease. Methods: The study group included 160 patients (123 male, 37 female; mean age: 61.2 years) who were classified (according to the highest grade pathological lesion in the oesophagus) as having Barrett’s intestinal metaplasia (IM; 88 patients), Barrett’s oesophagus with low‐grade dysplasia (LGD; 28 patients), high‐grade dysplasia (HGD; five patients), Barrett’s indefinite for dysplasia (n = 4), and Barrett’s adenocarcinoma (33 patients). A total of 91 of these patients had gastric antral specimens available for study. The control group consisted of 214 consecutive, prospectively enrolled symptomatic patients (122 male, 92 female; mean age: 57.2 years) who underwent upper gastrointestinal endoscopy and in whom Barrett’s oesophagus or Barrett’s adenocarcinoma was not found. A modified Warthin–Starry method was used to detect H. pylori infection. Results: Oesophageal H. pylori infection was found in eight of 160 (5%) patients with Barrett’s oesophagus or Barrett’s adenocarcinoma. Helicobacter pylori organisms in the oesophagus were found only on non‐intestinalized cardiac or oxyntocardiac mucosa. All patients with oesophageal H. pylori infection and an antral biopsy available for study had antral H. pylori infection. Gastric antral H. pylori infection was significantly less prevalent in patients in the Barrett’s study group (15/91, 16.5%) than in the non‐Barrett’s control group (67/214, 31.3%; Fisher’s exact test, P = 0.01). Patients from the control group with an endoscopic diagnosis of duodenal ulcer, gastric ulcer, gastritis, or duodenitis had a significantly higher prevalence of infection compared with the Barrett’s group, but there was no difference in the infection prevalence in patients in the Barrett’s group and patients with reflux oesophagitis, hiatal hernia, no endoscopic abnormality, or any other diagnosis. Conclusions: Oesophageal H. pylori infection is uncommon in patients with Barrett’s IM, dysplasia, or adenocarcinoma, and may be restricted to non‐intestinalized columnar epithelium. Gastric H. pylori infection may have a protective effect for the development of Barrett’s oesophagus.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Science Pty</pub><pmid>10696939</pmid><doi>10.1046/j.1440-1622.2000.01737.x</doi><tpages>8</tpages></addata></record>
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subjects adenocarcinoma
Adenocarcinoma - epidemiology
Adenocarcinoma - microbiology
Aged
Barrett Esophagus - epidemiology
Barrett Esophagus - microbiology
Barrett’s oesophagus
Esophageal Neoplasms - epidemiology
Esophageal Neoplasms - microbiology
Female
Gastric Mucosa - microbiology
Gastric Mucosa - pathology
Gastroesophageal Reflux - epidemiology
Gastroesophageal Reflux - microbiology
gastro‐oesophageal reflux disease
Helicobacter Infections - epidemiology
Helicobacter pylori
Humans
Male
Metaplasia - microbiology
Middle Aged
oesophageal adenocarcinoma
oesophagitis
oesophagus
Prevalence
title PREVALENCE OF HELICOBACTER PYLORI INFECTION IN 160 PATIENTS WITH BARRETT’S OESOPHAGUS OR BARRETT’S ADENOCARCINOMA
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