Abstract: Objective To determine the relationship between H. pylori infection and the anatomic distribution of chronic atrophic gastritis, a cross-sectional study was carried out in a population at high risk of gastric cancer.Methods From 1989 to 1990, 3 400 residents aged 35⁶4 in Linqu County, Shandong Province in China received gastroscopic examinations with biopsies taken from 7 standard sites in the stomach and the status of H. pylori infection of each participant was determined by ELSIA. The relationship between H. pylori infection status and the extension of CAG in gastric mucosa was analyzed.Results A total of 1 428 subjects were diagnosed of CAG and 801(56.1%) of those with CAG were serum H. pylori antibody positive. The proportion of CAG with more extensive distribution among H. pylori infection positive was significantly higher than the subjects with H. pylori infection negative (52.2% vs 36.2%, OR 3.2, 95% CI: 2.4～4.4, sex and age adjusted).Conclusion H. pylori infection was more likely to play an important role in on the progression of CAG from local to extensive distribution in the gastric mucosa. This population-based study provides further evidence that H. pylori infection is an important risk factor for the progression of CAG.

Key words: H. pylori, chronic atrophic gastritis, anatomic distribution, cross-sectional study