Long-term sequelae of Helicobacter pylori gastritis

Lancet. 1995 Jun 17;345(8964):1525-8. doi: 10.1016/s0140-6736(95)91084-0.


Chronic Helicobacter pylori gastritis has been put forward as a risk factor for development of gastric mucosal atrophy and gastric cancer. The purpose of our study was to investigate the long-term effects of H pylori gastritis on the gastric mucosa. We prospectively studied 49 subjects negative for H pylori and 58 positive subjects for a mean follow-up of 11.5 years (range 10-13 years). Serum samples were obtained at the initial and follow-up visits for determination of H pylori IgG antibodies. Gastroscopies with biopsy sampling were done in all patients at both visits. Biopsy specimens were used for assessment of H pylori infection and histology. Development of atrophic gastritis and intestinal metaplasia occurred in 2 (4%) uninfected and 16 (28%) infected subjects. Regression of atrophy was noted in 4 (7%) infected subjects. Development of atrophic gastritis and intestinal metaplasia was significantly associated with H pylori infection (p = 0.0014; odds ratio 9.0, 95% CI 1.9-41.3). The proportion of atrophic gastritis in the study population showed an annual increase of 1.15% (0.5-1.8%). We conclude that H pylori infection is a significant risk factor for development of atrophic gastritis and intestinal metaplasia. Our findings support strongly the causative role of this infection in gastric carcinogenesis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Gastric Mucosa / pathology*
  • Gastritis / complications
  • Gastritis / immunology
  • Gastritis / microbiology*
  • Gastritis / pathology
  • Gastritis, Atrophic / etiology
  • Gastroscopy
  • Helicobacter Infections* / complications
  • Helicobacter Infections* / immunology
  • Helicobacter Infections* / pathology
  • Helicobacter pylori* / immunology
  • Humans
  • Immunoglobulin G / blood
  • Intestines / pathology
  • Male
  • Metaplasia
  • Middle Aged
  • Odds Ratio
  • Peptic Ulcer / etiology
  • Peptic Ulcer / pathology
  • Prospective Studies
  • Risk Factors
  • Stomach Neoplasms / etiology


  • Immunoglobulin G