Clinical and Experimental Gastroenterology (Oct 2019)
Association Between Gastric Lymphoid Follicles (Precursor Of MALT Lymphomas) And H. pylori Infection At A Referral Hospital In Iran
Abstract
Homayoon Bashiri,1,2 Abbas Esmaeilzadeh,3 Hassan Vossoughinia,3 Kamran Ghaffarzadegan,4 Hamid Reza Raziei,5 Arezoo Bozorgomid1 1Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; 2Department of Internal Medicine, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran; 3Gastroenterology and Hematology Department, Faculty of Medicine, Ghaem Hospital, Mashhad, Iran; 4Pathology Department, Education and Research Department, Razavi Hospital, Mashhad, Iran; 5Department of Oncology and Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranCorrespondence: Arezoo BozorgomidInfectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, IranTel +98 918 872 8269Email [email protected]: Mucosa-associated lymphoid tissue (MALT) is the most common endoscopic finding in Helicobacter pylori positive patients that can progress to MALT lymphoma after a prolonged antigenic contact. This study was aimed to evaluate the prevalence of lymphoid follicles and aggregates (precursors of MALT lymphomas) in gastric mucosal biopsies and their correlation with H. pylori infection.Patients and methods: In this study, 100 patients who had undergone an upper gastrointestinal endoscopy were enrolled. Five biopsy specimens were taken each patient through screening endoscopy and histopathological changes were evaluated and graded using the Wotherspoon System. The clinical background and H. pylori infection status were also investigated.Results: Among the 100 cases in our series, 79 patients (79%) showed evidence of MALT in at least one biopsy specimen taken from the stomach and 21 cases (21%) had no evidence of MALT. H. pylori infection was detected in 74 (74%) patients. Lymphoid follicles were detected more frequently in H. pylori-positive patients (59%) compared to H. pylori-negative cases (3%) (P<0.001).Conclusion: The frequency of lymphoid follicles and aggregates in gastric mucosal is associated with H. pylori infection. Further community-based studies in larger sample sizes using a combination of microscopic methods and PCR assay are required for effective monitoring of H. pylori infection.Keywords: gastritis, Helicobacter pylori, lymphoid aggregate, lymphoid follicle