Brief Article
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World J Gastroenterol. Sep 28, 2012; 18(36): 5101-5105
Published online Sep 28, 2012. doi: 10.3748/wjg.v18.i36.5101
Predictive value of neutrophil infiltration as a marker of Helicobacter pylori infection
Xiao-Qing Xu, Zhen-Hua Wang, Jing-Xian Liao, Xiao-Yu Chen, Wen-Zhong Liu, Shu-Dong Xiao, Hong Lu
Xiao-Qing Xu, Zhen-Hua Wang, Jing-Xian Liao, Xiao-Yu Chen, Wen-Zhong Liu, Shu-Dong Xiao, Hong Lu, Department of Gastroenterology, Shanghai Renji Hospital, Shanghai Institute of Digestive Disease, Shanghai Jiaotong University School of Medicine, 145 Middle Shandong Rd, Shanghai 200001, China
Author contributions: Xu XQ performed this work and wrote the manuscript; Wang ZH and Liao JX collected patient data; Chen XY performed the histological examination; Liu WZ and Xiao SD performed the endoscopy; Lu H designed the project, directed the study and revised the draft.
Supported by The grant for Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, Shanghai Jiao Tong University School of Medicine; and National Natural Science Foundation of China, No. 81170355
Correspondence to: Hong Lu, MD, PhD, Department of Gastroenterology, Shanghai Renji Hospital, Shanghai Institute of Digestive Disease, Shanghai Jiaotong University School of Medicine, 145 Middle Shandong Rd, Shanghai 200001, China. honglu02@yahoo.com
Telephone: +86-21-63200874 Fax: +86-21-63266027
Received: January 31, 2012
Revised: April 18, 2012
Accepted: May 5, 2012
Published online: September 28, 2012
Abstract

AIM: To evaluate the predictive value of neutrophil infiltration as a marker of Helicobacter pylori (H. pylori) infection.

METHODS: A total of 315 patients with dyspepsia symptoms who underwent upper gastrointestinal endoscopy were enrolled in this study. Biopsies were evaluated using the updated Sydney system. The medication history of all patients in the preceding 4 wk was recorded. The diagnosis of H. pylori infection was based on 13C-urea breath test at least 4 wk after withdrawal of antisecretory drugs, antibiotics and related drugs. For the patients with subtotal gastrectomy, the diagnosis of H. pylori infection was based on anti-H. pylori immunoglobulin G (IgG) antibody. Serum anti-H. pylori IgG antibody was measured by enzyme-linked immunosorbent assays (Biohit, Finland).

RESULTS: The sensitivity, specificity, positive predictive value and negative predictive value of neutrophil infiltration in the diagnosis of H. pylori infection were 92.3%, 83.5%, 77.4% and 94.7%, respectively. Neutrophil infiltration of gastric mucosa in the histological analysis was strongly associated with H. pylori infection (77.4% vs 5.3% in the neutrophil infiltration negative group, P = 0.000). Moderate neutrophil infiltration was more frequent in H. pylori infection when compared to mild infiltration (81.8% and 75%, respectively), but did not reach statistical significance. For those patients with negative rapid urease test, H. pylori was detected in 73.2% of patients with positive neutrophil infiltration on histology. In patients with subtotal gastrectomy, the diagnostic accuracy of neutrophil infiltration in H. pylori infection was 50%.

CONCLUSION: Neutrophil infiltration is closely associated with H. pylori and may be recognized as a sign of this infection.

Keywords: Helicobacter pylori; Histology; Neutrophil; Sensitivity; Specificity