Helicobacter pylori and precancerous conditions of the stomach: The frequency of infection in a cross-sectional study of 79 consecutive patients with chronic antral gastritis in Yaoundé, Cameroon

Abstract

Introduction: The study aimed at determining the different types of precancerous conditions of the stomach and searches the frequency of
Helicobacter pylori in these lesions in patients with chronic antral gastritis in Yaounde, Cameroon.

Methods: Five gastric biopsies were performed during upper  gastrointestinal endoscopy for pathology and fixed in formol 10% before being coated in paraffin. Both the modified Giemsa and Periodic acid of Shift – Alkaline blue stains were used for the histological diagnosis of Helicobacter pylori infection. Hematoxylyn and eosin stain was used to determine the activity of gastritis, atrophic gastritis and intestinal  metaplasia in accordance to the Sydney’s classification of gastritis.
Data were analysed using both the Epi info 6.04 and Excel 2007 softwares. Means and their standard deviations, medians and their interquartiles
(IQR) were calculated. Proportions were established for qualitative variables and chi square analysis done in this study with a p value set at 0.05.

Results: Seventy-nine patients with chronic antral gastritis were enrolled, of which 43 (54.4%) were male, median age: 43 years (range from 21 to 70 years). The rate of atrophic gastritis was 74.7% (59/79). The activity of atrophic gastritis was mild in 47.5% (28/59) of cases, moderate in 47.5% (28/59) and severe in 5% (5/59). Intestinal metaplasia and follicular  gastritis were present in 6.3% (5/79), and 10.1% (8/79), respectively.
Concerning Helicobacter pylori infection, 71.2% (42/59) of patients with atrophic gastritis tested positive against 28.8% (17/59) who tested negative (p = 0.00003). Helicobacter pylori infection was related to the severity of gastric atrophy (p = 0.0001). Among patients with intestinal
metaplasia and follicular gastritis, the proportion of those who tested positive for Helicobacter pylori infection was 80% (4/5), and 75% (6/8),
respectively. There were no significant differences in the occurrence of atrophic gastritis according to age groups (p = 0.908).

Conclusion: This study concludes that atrophic gastritis, which is most often caused by Helicobacter pylori, is the most frequent precancerous condition of stomach in Cameroon. Routine gastric sampling for pathologic analysis is mandatory for effective diagnosis and surveillance of Helicobacter pylori infection and precancerous conditions of the stomach.