Helicobacter pylori in surgical specimens from patients with resectable gastric adenocarcinoma.

BACKGROUND: To investigate the prevalence of Helicobacter pylori (H. pylori) in surgical specimens from patients with respectable gastric adenocarcinoma using a histological method, and to study the specific biology of H. pylori-associated gastric cancer. MATERIALS AND METHODS: The presence of H. pylori in resected specimens from 276 patients treated between October 1994 and October 1996 was evaluated histologically using hematoxylin-eosin stain. Clinicopathologic data, including age, gender, cancer location, invasion depth, histologic type (intestinal or diffuse), stage (early or advanced), and the histology of the noncancerous gastric mucosa, were compared between patients testing positive and those testing negative for H. pylori. RESULTS: The overall positive rate of H. pylori was 27.5%. H. pylori-positive gastric cancer was frequently associated with atrophic gastritis or intestinal metaplasia in the noncancerous tissue, but was not associated with other variables. CONCLUSION: The results contradict the prevailing concept that H. pylori rarely colonizes in the metaplastic mucosa. To determine whether patients who have normal mucosa with superficial gastritis have a lower seroprevalence of H. pylori, further serologic study of the IgG antibody against H. pylori is mandatory. Our histologically positive rate is relatively lower than the seropositive one. More tissue samplings and special stains may provide more precise results.