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Saitoh K. Ohkura Y.
Department of Pathology, International Medical Center of Japan, Tokyo.
A total of 773 gastric mucosas taken from 653 patients who were endoscopically diagnosed as normal, or having reddening, irregular mucosa, erosion, small ulcer or scar were examined pathologically according to the Sydney system to study the role of H. pylori in the occurrence and development of chronic active gastritis, acute erosive gastritis and ulcer. H. pylori were detected in higher frequency in lesions showing active inflammation with neutrophil infiltration and necrosis of the mucosa. The presence of H. pylori was correlated with the degree of lymphocyte infiltration, but not with the degree of intestinal metaplasia, mucosal atrophy and location in the stomach. Reddening and irregular mucosas were found histologically to be chronic active gastritis. These results suggested that H. pylori causes active inflammation in the gastric rucosa, and that milder inflammation causes reddening or irregularity of the mucosa, whereas severer inflammation causes erosion and ulcer. There is no essential difference between chronic active and acute erosive gastritis.