Published online Nov 21, 2023. doi: 10.3748/wjg.v29.i43.5834
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
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 accura
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.
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
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).
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.