Peng YH, Feng X, Zhou Z, Yang L, Shi YF. Helicobacter pylori infection in Xinjiang Uyghur Autonomous Region: Prevalence and analysis of related factors. World J Gastroenterol 2023; 29(43): 5834-5847 [PMID: 38074913 DOI: 10.3748/wjg.v29.i43.5834]
Corresponding Author of This Article
Yun-Fei Shi, MD, PhD, Doctor, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. shiyunfei@bjmu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Nov 21, 2023; 29(43): 5834-5847 Published online Nov 21, 2023. doi: 10.3748/wjg.v29.i43.5834
Helicobacter pylori infection in Xinjiang Uyghur Autonomous Region: Prevalence and analysis of related factors
Yu-Hua Peng, Xue Feng, Zhong Zhou, Lei Yang, Yun-Fei Shi
Yu-Hua Peng, Zhong Zhou, Department of Pathology, Traditional Chinese Medical Hospital of Xinjiang Uygur Autonomous Region, The Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
Xue Feng, Department of Laboratory Medicine, Traditional Chinese Medical Hospital of Xinjiang Uygur Autonomous Region, The Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
Lei Yang, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, China
Yun-Fei Shi, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing 100142, China
Co-first authors: Yu-Hua Peng and Xue Feng.
Author contributions: Peng YH and Feng X collected samples and clinicopathological data, participated in the data analysis and drafted the manuscript; Zhou Z finished the pathological experimental procedures; Yang L performed the statistical analysis; Shi YF designed and supervised the study, revised the manuscript; and all authors read and approved the final manuscript.
Institutional review board statement: The study was approved by the Science and Research Office of Traditional Chinese Medical Hospital of Xinjiang Medical University (Urumqi).
Informed consent statement: As a pure retrospective study, and no intervention and impacts on the diagnosis and treatment of the patients involved, informed consent in our study was waived as approved by the Ethics Committee of the hospital.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun-Fei Shi, MD, PhD, Doctor, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pathology, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. shiyunfei@bjmu.edu.cn
Received: August 19, 2023 Peer-review started: August 19, 2023 First decision: September 28, 2023 Revised: October 10, 2023 Accepted: October 29, 2023 Article in press: October 29, 2023 Published online: November 21, 2023 Processing time: 92 Days and 16 Hours
Abstract
BACKGROUND
14C urea breath test (14C UBT) and immunohistochemical staining (IHC) are widely used for detection Helicobacter pylori (H. pylori) infection with different sensitivity, and there is a difference in H. pylori infection rate in Uyghur and Han ethnic groups. Both need large cohort studies to evaluate the differences more accurately.
AIM
To analyze the difference between 14C UBT and IHC for H. pylori detection in Xinjiang Uyghur Autonomous Region and the difference between Uyghur and Han populations.
METHODS
There were 3944 cases of H. pylori infection detected by both IHC and 14C UBT at the same time (interval < 1 wk, with sampling site including gastric antrum, selected from 5747 patients). We compared the sensitivity of 14C UBT and IHC. We also compared 555 pairs of Han/Uyghur cases (completely matched for gender and age) for their H. pylori infection rates. The overall H. pylori infection rate of all 5747 cases and the correlation with other clinicopathological data were also further analyzed. SPSS V23.0 software was used for statistical analysis.
RESULTS
The sensitivity was 94.9% for 14C UBT and 65.1% for IHC, which was a significant difference (n = 3944, P < 0.001). However, among those cases negative for H. pylori by 14C UBT (detection value ≤ 100), 4.8% were positive by IHC. Combining both methods, the overall H. pylori infection rate was 48.6% (n = 5747), and differences in gender, age group, ethnicity and region of residence significantly affected the H. pylori positive rates. According to age group (Han/Uyghur), the positive rates were ≤ 30 years (62.2%/100.0%), 31-40 years (45.2%/85.7%), 41-50 years (47.2%/79.2%), 51-60 years (44.6%/76.1%), 61-70 years (40.9%/68.2%), 71-80 years (41.7%/54.1%) and ≥ 81 years (42.9%/NA). The H. pylori infection rates of Han/Uyghur paired cases were 41.4% and 73.3%, which was a significant difference (P < 0.001) (555 pairs). H. pylori positivity was significantly related to moderate-severe grade 2-3 chronic/active gastritis and intestinal metaplasia (all P < 0.05).
CONCLUSION
The sensitivity of 14C UBT was significantly higher, but combined application can still increase the accuracy. The prevention H. pylori should be emphasized for Uygur and young people.
Core Tip: The sensitivity of 14C urea breath test (14C UBT) for detecting Helicobacter pylori (H. pylori) is significantly higher than that of immunohistochemistry (IHC) with endoscopy specimens. Combination of 14C UBT and IHC is necessary to improve detection accuracy, and increasing the number of biopsy specimens (≥ 2) can improve the positive rate significantly. The overall rate of H. pylori infection in Xinjiang Uyghur Autonomous Region was higher than in previous studies. H. pylori infection was more prevalent in the Uyghur population and the infection rate decreased as age increased. Therefore, the prevention and intervention of H. pylori infection in Xinjiang Uyghur Autonomous Region should emphasize Uyghur and young people.
