The Study of the Positivity of Helicobacter pylori in the Intestinal Metaplasia Detected by Methylene Blue Chromoendoscopy and Histology

Chang, Rin; Chang, Young Woon; Kim, Byung Ho; Kim, Hyo Jong; Dong, Seok Ho; Lee, Joung Il; Lee, Jung Hwan; Kwon, Sun Hee; Kim, Yoon Hwa

Abstract

BACKGROUND AND AIMS
To assess the relationship between the intestinal metaplasia, Helico-bacter pylori infection, and H. pylori positivity, the difference in the type of intestinal metaplasia according to H. pylori status were examined. METHODS: Chromoendoscopy by methylene blue stain method was performed to assess the diagnostic viability for the detection of intestinal metaplasia in subjects who having histologically determined intes-tinal metaplasia.
RESULTS
Intestinal metaplasia was found in 35 subjects. Of these, 21subjects (60%) were male and 14 subjects (40%) were female. Of 35 subjects, 26 subjects were H. pylori positive cases (74.3%) and 9 subjects were H. pylori negative cases (25.7%). The mean age of intestinal metaplasia subjects was 51.5 8.9 years. Of these, the mean age of H. pylori positive subjects was 49.5 8.0 years, whereas the mean age of H. pylori negative subjects was 57.2 9.2 years (p <0.05). On the type of intestinal metaplasia, 31 subjects showed type I (88.6%) and 4 subjects showed type II (11.4%). There was no statistical difference of intestinal metaplasia type according to H. pylori status. The diagnostic value of methylene blue chromoendoscopy in the diagnosis of intestinal metaplasia had a sensitivity of 82.4%, specificity of 100%, positive predictivevalue of 100% and negative predictive value of 75%.
CONCLUSIONS
Although a causal relationship between H. pylori infection and the histogenesis of intestinal metaplasia was not proven, it is suggested that H. pylori positive cases lead to an earlier development of intestinal metaplasia than H. pylori negative cases. Therefore, it is important to assess the probability of the development of gastric carcinoma through a follow up study.