H. pylori Infection and the Correlation to Chronic Active Gastritis Detected by the Histological Criteria of the Sydney System

Abstract

In Thailand, chronic active gastritis and chronic atrophic gastritis have not been given frequent mention. Our aim is to present the relationships of the many variables in histological classification of chronic bacterial gastritis by the Sydney System. This paper presents the prevalence of chronic active gastritis by studying the degree of H. pylori infection detected by the Modified Toluidine Blue staining (MTBs) and histological grading, using the Sydney System. A total of 355 dyspeptic patients who underwent endoscopy in Kawila hospital, Chiang Mai, northern Thailand from January 1996 to January 1998, were included in the study. Overall, 284 patients (80.3 %) had an H. pylori infection. Diagnosis varied from normal, chronic gastritis, and acute gastritis to chronic active gastritis in 11 (3.1 %), 95 (26.8 %), 0 (0 %), 249 (70.1 %) patients respectively. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of neutrophils presented with lymphocytes are 85.2, 90.1, 97.2, and 60.4 %, respectively. We conclude from the study that chronic active gastritis is a very common condition in Thailand. If chronic active gastritis is present, H. pylori is usually detected, and the degree of infection is well correlated to the degree of inflammation.