THE RELATIONSHIP OF HELICOBACTER PYLORI CYTOTOXIN-ASSOCIATED GENE A (Cag A) POSITIVE AND NEGATIVE WITH THE DEGREE OF GASTRITIS SEVERITY BASED ON THE HISTOPATHOLOGY

Fithria Alaina Dja‘far; Lidya Imelda Laksmi; Masrul Lubis; Gontar Alamsyah Siregar

Volume : VIII, Issue : IV, April - 2019

THE RELATIONSHIP OF HELICOBACTER PYLORI CYTOTOXIN-ASSOCIATED GENE A (Cag A) POSITIVE AND NEGATIVE WITH THE DEGREE OF GASTRITIS SEVERITY BASED ON THE HISTOPATHOLOGY

Fithria Alaina Dja 8216 Far, Lidya Imelda Laksmi, Masrul Lubis, Gontar Alamsyah Siregar

Abstract :

Introduction : Helicobacter pylori (H.pylori) is the commonest cause of chronic active gastritis in the world that is around 80%. Risk of prolonged chronic gastritis into atrophy and metaplasia in gastric mucosa which leads to the occurrence of gastric cancer. H.pylori carry different virulence factors such as urease, flagellar, VacA, and CagA, which plays an important role in the invasion, colonization and proliferation. CagA can activate a number of signal transduction pathways that resembles released by growth factor receptors, occurs continuously, involved in binding and disrupting the epithelial junction resulting in abnormalities in the tight junctions, cell polarity and cell differentiation. Objective to identify the relationship H.pylori CagA(+) and CagA(-) to the severity of gastritis by histopathology. Methods: The study was conducted with a cross-sectional design of the 30 patients with dyspepsia based on Rome III criteria, using PADYQ scores. Furthermore, endoscopy and biopsy to see gastritis, CLO checks for the presence of H.pylori, PCR for virulence examination CagA and Histopathological examination to examination of chronic inflammatory infiltration neutrofi, atrophy and metaplasia Results: Of the 30 subjects, 18 men and 14 women with a mean age of 53.3 years, were found more subjects with gastritis H. pylori CagA(+) 21(70%) and CagA(-) 9(30%). Then found a significant association between CagA status with the degree of chronic inflammation (p=0.032) in which patients with H.pylori CagA(+) at risk of 3.43x experiencing gastritis with chronic inflammation, the degree of infiltration of neutrophils (p=0.037) with the risk of 4.5x experience gastritis with infiltration of neutrophils, and the degree of atrophy (p=0.041) risk of atrophic gastritis 2.17x experiencing moderate + severe. But the absence of statistically significant relationship between CagA status with the degree of intestinal metaplasia (p = 0.077). Conclusion: There is a significant relationship between H.pylori CagA status with the degree of chronic inflammation, neutrophil infiltration degree and the degree of atrophy. There is no significant relationship between CagA status with the degree of intestinal metaplasia.