Helicobacter pylori induces gastritis and oxidative stress after distal gastrectomy

BACKGROUND/AIMS: Helicobacter pylori is a carcinogen for gastric cancer. There have been few reports on carcinogenesis about H. pylori infection in the gastric remnant after distal gastrectomy. The relationship between carcinogenesis and H. pylori infection was studied by means of inflammation and oxidative stress. METHODOLOGY: Ninety-seven patients who had undergone curative distal gastrectomy for gastric cancer were studied. All patients underwent endoscopic examination 3 months after surgery. The presence of H. pylori was determined using urease rapid test, hematoxylin-eosin staining, and immunohistochemical staining. Fifty-one patients were positive (group A) and 46 patients were negative (group B). The grades of remnant gastritis were scored by updated Sydney System. 8-Hydroxydeoxyguanosine (8-OHdG) as an oxidative stress marker, was analyzed immunohistochemically, and graded in 4 grades. RESULTS: Both the neutrophil infiltration score and 8-OHdG expression score was higher in group A than group B (p = 0.03 and 0.05). The correlation between the 8-OHdG expression score and the neutrophil infiltration score was significant (p = 0.02). CONCLUSIONS: As gastritis is related to oxidative stress, H. pylori infection is suspected to play an important role in carcinogenesis in the gastric remnant.