Helicobacter pylori and gastric cancer. An endoscopic series

In a series of 92 patients with gastric cancer who had biopsies of the antrum and fundus, we compared the 65 patients with Helicobacter pylori (71%) with the 27 negative patients. No difference was observed for age, gender or histology (intestinal or diffuse). Significant differences concerned location (11% of H. pylori positive patients had a cancer at the cardia or fundus vs 44%), the presence of a normal mucosa (3% vs 30%) and atrophy in the antrum (53% vs 17%). Seven of the ten patients with a normal mucosa had a cancer located at the cardia (p < 0.05) and in nine of the eleven patients younger than fifty, the cancer was of the diffuse type (p < 0.005). Thus, patients with H. pylori and gastric cancer differ from those uninfected. Of future concern is the large increase in cancers of the cardia, a cancer unassociated with H. pylori.