Lewisb and ABH expression in gastric mucosa: lack of inter-relation with Helicobacter pylori colonisation and occurrence of gastric MALT lymphoma

Accepted for publication 23 January 1997 Abstract Background-Blood group Lewisb antigens mediate Helicobacter pyloni attachment to gastric mucosa with attachment being particularly strong in subjects with ABH blood group 0. Aims-To determine whether H pyloni colonisation or the occurrence of gastric mucosa associated lymphoid tissue (MALT) lymphomas might be related to gastric Lewisb expression or occurrence of particular ABH blood groups on gastric mucosa. Patients-Gastric resection specimens from 89 cases with gastric MALT lymphoma and gastric mucosal biopsy specimens from 95 patients undergoing upper endoscopy due to upper gastrointestinal complaints, including five cases with gastric MALT lymphoma, were studied. Methods-Hpylon was visualised with the Warthin-Starry stain. Immunostaining (Lewisb, Lewisa, A, B) was performed by applying a three step immunoperoxidase technique and indirect immunofluorescence staining on formalin fixed and paraffin wax embedded tissue. In 40 patients red blood cell Lewis phenotype and ABH blood groups were additionally determined by haemagglutination assay. Results-Gastric surface epithelial celis showed an immunoreactivity to blood groups A, B, and AB in 80 (43-5%), 22 (12%)/, and 11 (6%) cases respectively and no immunoreactivity to any of these blood group substances (blood group 0) in 71 (38.5%) patients. Lewisb expression of all gastric surface epithelial cells (secretor status) was found in 130 (707%) cases. Lewisa expression of all gastric surface epithelial cells (non-secretor status) was found in 36 (19-6%) cases, secretor status remained unclassified in 18 (9.8%) patients. Colonisation with H pylon was found in 134 (72/8%) cases. The occurrence of H pylon was neither significantly associated with secretor status nor with certainABH blood groups. The infiltration of gastric mucosa with MALT lymphoma was highly significantly associated with H pyloni colonisation (p<0-0003) but neither with secretor status nor with certain ABH blood groups. There was no inter-relation between secretor status or ABH blood groups and type, stage, grade of, and survival after MALT lymphoma. Conclusion-This study failed to show an inter-relation between secretor status or particularABH blood groups and eitherH pylon infection or the occurrence of gastric MALT lymphomas. (Gut 1997; 41: 37-42)