Relationship of gastric metaplasia of the duodenum with age, duodenal ulcer and Helicobacter pylori infection

Abstract

Gastric metaplasia of the duodenum is thought to be associated with the pathogenesis of duodenal ulcer. We investigated the pathological features of gastric metaplasia and their relation to age, gender, duodenal ulcer and H. pylori infection. Methods : We reviewed the duodenal endoscopic findings of 535 patients (age range: 0 to 87) and the microscopic slides of the duodenal biopsy specimens. Results : Gastric metaplasia was first noted at the age of 4 and the prevalence increased thereafter until the patients' mean age reached about 30. The prevalence of gastric metaplasia was 53.7% after 30 years of age, As the metaplasia became severer, it became more polypoid in appearance and it more often contained parietal cells. Gastric metaplasia was more frequently observed or severe in duodenal ulcer patients, in males and in the first portion of the duodenum than in patients without duodenal ulcer, in females and in the second portion, respectively. There was a lack of correlation between gastric metaplasia and H. pylori infection. Conclusions : The prevalence and/or severity of gastric metaplasia of the duodenum increases with age, and it is thought that most duodenal ulcers develop in the areas of gastric metaplasia.