“ONE YEAR INCIDENCE OF GASTRIC DYSPLASIA AND ITS RELATION TO H.PYLORI INFECTION IN 2.270 CONSECUTIVE GASTROSCOPIES, IN ROME”

OBJECTIVES: To determine, in 2.270 consecutive gastroscopies, one year incidence of gastric dysplasia, its association with H.pylori infection, genotypes, feasibility to culture H.pylori and dysplasia course during the 3-6 months of follow–up. METHODS: In the period Nov 2011- Nov 2012, 2.270 patients underwent gastroscopy in two endoscopic units. There were 1.258 women (mean age 58years; range18-101yrs) and 1.012 men ( mean age 58 years, range 20-92 yrs). At the interval of 3-6 month after the first diagnosis of gastric dysplasia the patients underwent second gastroscopy with biopsies from the antrum, corpus and fundus for histology and culture. A third control gastroscopy was performed in some patients. Gastritis was assessed according to the updated Sydney System. CagA and vacA genotypes were identified by PCR. RESULTS: Dysplasia was diagnosed in 21 patients(0,9%), mean age 62 yrs. Culture was performed in 17pts but H.pylori isolates were obtained from 7 pts only. In 4 pts biopsies for culture were not taken because of the initial H.pylori negative histology. In remaining 10 pts there was no growth. In 6 pts strains were vacAs1m1, cagA+ and in one vacAs1m2, cagA+.CONCLUSIONS: Study of genomic H.pylori profile can be impaired by negative culture. In our study gastric dysplasia was associated in most cases with cagA and vacAs1,m1 genotype. Follow-up ( minimum 3 controls) of patients with dysplasia is mandatory.