Gastric cancer and Helicobacter pylori infection in the eastern Libya: a descriptive epidemiological study.

Original article


Elzouki AN 1, Buhjab SI 2, Alkialani A 3, Habel S 4, Sasco AJ 5.

1-Department of Medicine, Hamad General Hospital, HMC, Doha, Qatar 2-Department of Medicine, Benghazi University, Benghazi, Libya 3-Department of Pathology, Benghazi University, Benghazi, Libya 4-Department of Surgery, Omar Almokhtar University, Albieda, Libya 5-Epidemiology for Cancer Prevention, Team on HIV, Cancer and Global Health, Inserm U 897, Bordeaux Segalen University, 33076 Bordeaux, Cedex, France

Arab J Gastroenterol. 2012 Jun;13(2):85-8


Background and study aims
The aim of this study was to determine the pattern of histologically-proven gastric cancer in Eastern Libya and explore its association with Helicobacter pylori infection.
Patients and methods
The registries of the Departments of Histopathology, Faculty of Medicine, Benghazi University and Oncology, Al-Jomhoria Hospital, Benghazi, were reviewed for cases with primary gastrointestinal cancer from January 2000 to December 2002 (sole Histopathology and Oncology Departments in Eastern Libya). Slides of hematoxylin and eosin stain of gastric cancer patients were re-stained to detect H. pylori. The American Joint Committee on Cancer Tumor, Node, Metastasis staging was used for clinical and pathologic staging. Gastric cancer biopsy materials were classified into intestinal or diffuse type according to Lauren criteria.
One hundred and fourteen cases of gastric cancer were diagnosed. Tumor stages were: 2 (14%), 3 (21%), 4 (57%) and unknown (8%). Most common site of involvement was the antrum (48%). Diffuse adenocarcinoma occurred in 56 patients (49.1%), intestinal adenocarcinoma in 46 (40.4%) and malignant gastric lymphoma in 12 (10.5%). The overall frequency of H. pylori infection was 63.2% (72/114), more frequent in intestinal adenocarcinoma (71.7%) and malignant lymphoma (66.6%) than diffuse adenocarcinoma (55.3%). The frequency of gastric cancer increased throughout the three years of study.

The majority of the patients were diagnosed in locally advanced or metastatic stage. Clearly more efforts need to be given to early detection. We showed a stronger association of H. pylori infection with intestinal type gastric adenocarcinoma and malignant lymphoma than diffuse adenocarcinoma suggesting that H. pylori infection is the most probable causal factor of gastric cancer in this part of Libya.

Keywords: Gastric cancer and Helicobacter Pylori infection in the Eastern Libya: A descriptive epidemiological study