Ethnic difference of Helicobacter pylori gastritis: Korean and Japanese gastritis is characterized by male- and antrum-predominant acute foveolitis in comparison with American gastritis

World J Gastroenterol. 2005 Jan 7;11(1):94-8. doi: 10.3748/wjg.v11.i1.94.


Aim: To investigate the clinicopathological factors underlying the ethnic differences of Helicobacter pylori gastritis and cancer.

Methods: We analyzed clinicopathological parameters of gastric biopsies having H pylori infection that were randomly selected from different ethnic populations including 147 Americans, 149 Japanese, and 181 Koreans.

Results: Males were predominant in Japanese and Korean populations (77.9 and 67.4% respectively) in comparison with Americans (48.3%) (P<0.001). H pylori gastritis in Koreans and Japanese was characterized by the predominant antral involvement. In the antrum, neutrophilic infiltration into the proliferative zone of pit, i.e. acute foveolitis, was more frequent in Koreans (82%) than in Japanese (71%) (P<0.05) and Americans (61%) (P<0.001). Interstitial neutrophilic infiltration, intestinal metaplasia and atrophy were also frequent in Koreans and Japanese. In the body, the prevalence of acute foveolitis was not significantly different among the populations while chronic interstitial inflammation and lymphoid follicles were more pronounced in the body of Americans than in the body of others (P<0.01).

Conclusion: The male-, and antrum-predominant H pylori gastritis in Koreans and Japanese is compatible with the pattern of sex and topographical distribution of gastric cancer incidence. Our data suggest that persistent acute foveolitis at the proliferative zone is a crucial step in the gastric carcinogenesis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Atrophy
  • Biopsy
  • Chronic Disease
  • Epithelial Cells / immunology
  • Epithelial Cells / microbiology
  • Epithelial Cells / pathology
  • Female
  • Gastritis / ethnology*
  • Gastritis / immunology
  • Gastritis / pathology
  • Helicobacter Infections / ethnology*
  • Helicobacter Infections / immunology
  • Helicobacter Infections / pathology
  • Helicobacter pylori*
  • Humans
  • Intestines / pathology
  • Japan / epidemiology
  • Korea / epidemiology
  • Lymphoid Tissue / pathology
  • Male
  • Metaplasia
  • Middle Aged
  • Neutrophils / pathology
  • Pyloric Antrum / immunology
  • Pyloric Antrum / microbiology*
  • Pyloric Antrum / pathology*
  • Sex Distribution
  • United States / epidemiology