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This study was conducted to investigate whether or not the eradication of H. pylori could lead to the regression of intestinal metaplasia (IM) in patients with either duodenal ulcer (DU) or benign gastric ulcer (BGU). The initial antral IM grade was 0.21 in the 72 patients of the H. pylori-eradicated DU group, this decreased to 0.17, 0.14, 0.13, and 0.09 after periods of four weeks, one year, two years, and four years, respectively, but without statistical significance. In the corpus of the DU group, where IM grade was low (0.02), there was no detectable change in IM. The initial antral IM grade of 0.69 in the 41 patients of the H. pylori-eradicated BGU group decreased substantially to 0.61, 0.44, and 0.39 after periods of four weeks and one and two years, respectively, but again without statistical significance. The initial corporal IM grade of the BGU group of 0.27 decreased to 0.20, 0.15, and 0.06 after periods of four weeks and one and two years, again without statistical significance. In contrast, the IM grades of the noneradicated DU group (N 5 20) and the BGU group (N 5 16) showed nearly no change in the antrum and corpus. Gastritis grades of antrum and corpus in the H. pylori-eradicated DU or BGU group significantly decreased with respect to time (P 5 0.0001), but there were no significant changes in the corresponding noneradicated groups. Although there was no statistical significance, IM decreased in the antrum and corpus of the stomach with BGU and in antrum of those with DU over a two to four-year period after H. pylori eradication, suggesting the possible reversibility of IM.
KEY WORDS: Helicobacter pylori; intestinal metaplasia; eradication; duodenal ulcer; gastric ulcer.
Chronic active gastritis caused by Helicobacter pylori is known to be associated with the development of gastric atrophy, intestinal metaplasia (IM), and carcinoma (1- 4). The eradication of H. pylori reduces the activity of the gastritis and the inflammatory score (5-11), but the effect of such eradication on the pathogenesis of IM has not yet been established. Although some workers have reported a regression in IM (10, 12), most have reported no significant change (5, 9, 11, 13, 14). This suggests that there might be a turning point in the...