Association of Helicobacter pylori Infection in Intestinal and Diffuse Types of Gastric Adenocarcinoma

Open Access

Abstract

Introduction: Gastric cancer is the fifth most common malignancy and the fourth leading cause of cancer-related death worldwide. Helicobacter pylori is a Group 1 carcinogen strongly associated with gastric malignancies. Gastric adenocarcinomas are classified into intestinal and diffuse types, which exhibit distinct biological characteristics. Studies on H. pylori prevalenceacross histological types have yielded conflicting results. Objectives: To determine the association of H. pylori infection in intestinal and diffuse types of gastric adenocarcinoma. Methods & Materials: This cross-sectional study was conducted in the Department of Pathology, Sylhet MAG Osmani Medical College, Bangladesh, from July 2011 to June 2012. Fifty patients with histologically confirmed gastric adenocarcinoma (intestinal or diffuse type) were enrolled. H. pylori infection was diagnosed using rapid urease test, histology with Giemsa stain, and serological ELISA, with infection confirmed if two of three methods were positive. Results: Patient age ranged from 25-80 years (mean 56.8±13.5 years). Males predominated (76.0%) with male:female ratio of 3.2:1. Intestinal-type comprised 68.0% and diffuse-type 32.0% of cases. Mean age was significantly lower in diffuse-type (50.4±5.1 years) than in intestinal-type (59.6±15.2 years; p<0.05). Males predominated in intestinal-type (91.2%), while females predominated in diffuse-type (56.2%; p<0.01). Overall, H. pylori positivity was 80.0%. Infection was present in 76.5% of intestinal-type and 87.5% of diffuse-type, with no statistically significant difference (p>0.05). Conclusions: H. pylori infection is highly prevalent in both intestinal and diffuse types of gastric adenocarcinoma in Bangladesh. Despite demographic differences between types, no significant difference in H. pylori infection rates was observed, suggesting its important role in the pathogenesis of both subtypes.