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Colonisation density and topographic localisation of Helicobacter pylori do not depend on the cagA status
  1. M Twisk1,
  2. J G Kusters3,
  3. A G Balk2,
  4. E J Kuipers3,
  5. R J L F Loffeld1
  1. 1Department of Internal Medicine, de Heel Zaans Medisch Centrum Zaandam, PO Box 210, 1500 EE Zaandam, The Netherlands
  2. 2Department of Pathology, de Heel Zaans Medisch Centrum Zaandam
  3. 3Department of Gastroenterology and Hepatology, University Hospital Dijkzigt Rotterdam, Dr Molewaterplein 40 3015 GD Rotterdam, The Netherlands
  1. Dr Loffeld r.loffeld{at}


Aims—To explore the correlation between the cagA status of Helicobacter pylori and the density and topographic localisation of H pylori.

Methods—Gastric antral biopsy specimens were taken from 716 consecutive patients, including 293 H pylori positive patients (124 men, 169 women; mean age, 52.6 years; range, 12–87). A serum sample was taken for determination of IgG anti-CagA antibodies (sensitivity of 94.4% and specificity of 92.5%). The density of H pylori was assessed semiquantitatively (grades I–IV) in biopsy specimens stained with the modified Giemsa stain. Topographic localisation was classified as follows: score A, H pylori closely attached to the mucosa; score B, H pylori attached to the mucosa and in the mucus; and score C, H pylori solely in the mucus.

Results—CagA antibodies were present in 154 (52.5%) of the patients. There was no significant difference in colonisation density and cagA status: grade I, 23 (14%); grade II, 78 (50.6%); grade III, 42 (27.5%); and grade IV, 11 (7.2%) in the cagA+ strains and 29 (21.2%), 57 (40.8%), 38 (27%), and 15 (11%), respectively, in the cagA strains. There was no difference in topographic localisation between cagA+ and cagAH pylori. Mean anti-CagA titres were 0.84, 0.84, 0.89, and 0.73 in patients with grades I–IV bacterial density, respectively.

Conclusion—Antibody titres do not correlate with H pylori density and there is no difference in density between cagA+ and cagAH pylori strains. In addition there is no difference in topographic localisation between cagA+ and cagA- H pylori strains.

  • Helicobacter pylori topography
  • Helicobacter pylori colonisation
  • density
  • antibody titres

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