Toshifumi Ohkusa, MD; Kazuhiko Fujiki, MD; Ichizen Takashimizu, MD; Jiro Kumagai, MD; Toru Tanizawa, MD; Yoshinobu Eishi, MD; Tetsuji Yokoyama, MD; Mamoru Watanabe, MD
Grant Support: In part by Takeda Chemical Industries, Ltd., Osaka, Japan.
Requests for Single Reprints: Toshifumi Ohkusa, MD, Department of Gastroenterology and Hepatology, School of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; e-mail, email@example.com.
Current Author Addresses: Drs. Ohkusa, Fujiki, Takashimizu, and Watanabe: Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Drs. Kumagai, Tanizawa, and Eishi: Department of Pathology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Dr. Yokoyama: Department of Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
Author Contributions: Conception and design: T. Ohkusa.
Analysis and interpretation of the data: T. Ohkusa, J. Kumagai, T. Tanizawa, Y. Eishi, T. Yokoyama.
Drafting of the article: T. Ohkusa.
Critical revision of the article for important intellectual content: T. Ohkusa, M. Watanabe.
Final approval of the article: T. Ohkusa, M. Watanabe.
Provision of study materials or patients: T. Ohkusa, K. Fujiki, I. Takashimizu.
Statistical expertise: T. Yokoyama.
Obtaining of funding: T. Ohkusa.
Administrative, technical, or logistic support: K. Fujiki, I. Takashimizu, J. Kumagai, T. Tanizawa, Y. Eishi, T. Yokoyama.
Collection and assembly of data: T. Ohkusa.
Glandular atrophy and intestinal metaplasia are precancerous lesions; whether Helicobacter pylori eradication affects these lesions is controversial.
To determine whether H. pylori eradication is associated with improvement in glandular atrophy and intestinal metaplasia after at least 1 year.
Single-blind, uncontrolled prospective trial.
Academic gastroenterology clinic in Japan.
163 consecutive patients with dyspepsia and H. pylori infection.
One-week course of a proton-pump inhibitor and antibiotic therapy.
Endoscopic examination with antral and corporal biopsy was done before treatment and at 1 to 3 and 12 to 15 months after treatment. Gastritis, atrophy, and metaplasia were graded according to the updated Sydney System.
In the 115 patients in whom H. pylori was eradicated, inflammation and mean neutrophil activity had decreased by 1 to 3 months, and both glandular atrophy in the corpus and intestinal metaplasia in the antrum had decreased by 12 to 15 months. Glandular atrophy in the corpus improved in 34 (89%) of 38 patients with atrophy before treatment, and intestinal metaplasia in the antrum improved in 28 (61%) of 46 patients who had metaplasia at baseline. In the 48 patients in whom eradication was unsuccessful, no significant histologic changes were observed.
In the year after successful H. pylori eradication, precancerous lesions improved in most patients.
Ohkusa T, Fujiki K, Takashimizu I, Kumagai J, Tanizawa T, Eishi Y, et al. Improvement in Atrophic Gastritis and Intestinal Metaplasia in Patients in Whom Helicobacter pylori Was Eradicated. Ann Intern Med. ;134:380–386. doi: 10.7326/0003-4819-134-5-200103060-00010
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Published: Ann Intern Med. 2001;134(5):380-386.
Gastroenterology/Hepatology, H. Pylori, Infectious Disease, Peptic Disease.
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