Helicobacter pylori in gastric cancer in India

Helicobacter pylori infection has been implicated in pathogenesis of gastric cancer. Since there is paucity of reports from developing countries on association of H. pylori with gastric cancer, we performed case control study to find out the relationship between H. pylori and gastric cancer and also compared characteristics of gastric cancer and H. pylori positivity in younger and older patients.

Gastrectomy (n = 37) or endoscopic biopsy (n = 43) samples from area adjoining the cancer were collected from 80 patients of gastric cancer. Tissue specimens were stained with hematoxylin-eosin and Giemsa stains and histological type of cancer was determined according to Lauren, as intestinal or diffuse type. The presence of H. pylori was assessed by Giemsa staining. Eighty age and sex matched patients with non-ulcer dyspepsia (NUD) served as controls.

Of 80 patients, 48 had intestinal type, 28 diffuse type and 4 had mixed type of gastric cancer. Tumour was located in antrum in 37, in body in 31, and at other sites in 12 cases. H. pyolri infection was present in 29 of patients compared to 36 patients with non-ulcer dyspepsia (p > 0.05, odd ratio 0.69, confidence interval 0.37-1.32). The positivity for H. pylori was higher in intestinal type than in diffuse type (p < 0.05) of gastric cancer but similar in patients with growth in antrum and body (p = NS) of stomach. There was no significant difference in tumor type, tumor site, frequency of intestinal metaplasia and H. pylori positivity (39% vs 35%, P > 0.05, odd ratio 1.19, confidence interval 0.44-3.23) in younger (< 45 yrs) and older (> 45 yrs) patients.

Approximately one-third of patients with gastric cancer show presence of H. pylori infection on histological examination. No difference in H. pylori positivity were observed in young and old patients of gastric cancer.