Investigation on the Relationsinp hetween Duodenal Ulcer and Atrophic Gastritis

There is accumulating evidence that gastric ulcer (GU) is positively associated and duodenal ulcer (DU) is negatively associated with the risk of developing stomach cancer. Aims: To investigate the relationship between duodenal ulcer and atrophic gastritis. Methods: The biopsy specimens of gastric mucosa of antrum, junction of antrum and corpus, and corpus in patients with DU, GU, complex ulcer (CU) and antral mucosa in patients with chronie gastritis (CG) were examined by histological stains; and then the incidence and degree of atrophy, intestinal metaplasia, chronie inflammatory activity and Helieobacter pylori (H. pylori) infection were statistically analyzed. Results: The incidence rates of gastric mucosal atrophy in antrum, junction and corpus of duodenal ulcer patients were 54. 2%, 9. 5% and 12. 4%, respectively, whilst those of intestinal metaplasia were 18. 9%, 2. 5% and 1. 5%, respectively. The incidenee rate of intestinal metaplasia of antral mucosa in DU patients was lower than that of GU, CU and CG patients. All patients with peptic ulcer and CG presented chronic inflammation in antral nmcosa. The incidence rates of chronic inflammation of corpus in DU, GU and CU patients also attained a very high level. The incidence rates of inflammatory activity of gastritis in DU, GU and CU patients were predominatly in the antrum, and were higher than that in chronic gastritis (P0. 05). The incidence rate of type Ⅰ intestinal metaplasia of antral mucosa in DU, GU and CU patients was 68. 1%, 43. 8% and 45. 0%. respectively, whereas the incidence rate of type Ⅲ intestinal metaplasia of these patients was 6. 4%, 25. 0% and 20.0%. respectively. Conclusions: Foeal atrophy and intestinal metaplasia can develop in the antral mucosa of DU patients. The incidence rate of intestinal metaplasia in the antral mueosa and type Ⅲ intestinal metaplasia are lowest in DU patients, which might account for the reason why DU patients have a lower risk for developing gastric cancer.