Comparison of Intestinal Metaplasia and Serum Pepsinogen Levels between Helicobacter pylori-Infected Duodenal Ulcer and Chronic Gastritis

Kim, Sang Woo; Chung, In Sik; Lee, Kang Moon; Lee, Dong Soo; Yoon, Jong Goo; Kim, Sung Soo; Yang, Young Sang; Choi, Myung Gyu; Han, Sok Won; Choi, Kyu Yong; Park, Doo Ho

Abstract

BACKGROUND/AIMS: The aim of this study was to investigate the differences in the frequency of intestinal metaplasia, its subtypes, and serum pepsinogen levels between Helicobacter pylori (H. pylori)-infected patients with duodenal ulcer and patients with chronic gastritis.
METHODS
We evaluated the area of atrophic change, frequency of intestinal metaplasia and subtypes, serum pepsinogen (PG) levels, and seropositivity of CagA and VacA in 25 H. pylori-infected patients with duodenal ulcer and 25 patients with chronic gastritis.
RESULTS
Eight percent of patients with duodenal ulcer showed open type, whereas 52% of patients with chronic gastritis showed it (p=0.001). The intestinal metaplasia was less frequently observed in patients with duodenal ulcer (36% vs. 68%, p<0.005). However, there was no difference in frequency of intestinal metaplasia subtypes between the two groups. The patients with duodenal ulcer showed significantly high serum PG I/II ratio (3.3+/-1.1 vs. 2.2+/-0.8, p<0.001). There was no difference in the seropositivity of CagA and VacA between the two groups.
CONCLUSION
H. pylori-infected patients with duodenal ulcer have the significantly smaller area of atrophic change and lower frequency of intestinal metaplasia than patients with chronic gastritis. Serum PG I/II ratio which is significantly high in patients with duodenal ulcer reflects the degree of the atrophic change of the gastric mucosa, but CagA and VacA do not.