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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Type I and type II Helicobacter pylori infection status and their impact on gastrin and pepsinogen level in a gastric cancer prevalent area
Lin Yuan, Jun-Bo Zhao, Ying-Lei Zhou, Ya-Bin Qi, Qiong-Ya Guo, Hai-Hui Zhang, Muhammad Noman Khan, Ling Lan, Chang-He Jia, Yan-Rui Zhang, Song-Ze Ding
Lin Yuan, Jun-Bo Zhao, Ying-Lei Zhou, Ya-Bin Qi, Qiong-Ya Guo, Hai-Hui Zhang, Muhammad Noman Khan, Ling Lan, Chang-He Jia, Yan-Rui Zhang, Song-Ze Ding, Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University, Henan Province, China
Lin Yuan, Jun-Bo Zhao, Ying-Lei Zhou, Ya-Bin Qi, Qiong-Ya Guo, Hai-Hui Zhang, Muhammad Noman Khan, Ling Lan, Chang-He Jia, Yan-Rui Zhang, Song-Ze Ding, Henan Provincial People’s Hospital, Henan Province, China
Ying-Lei Zhou, Ya-Bin Qi, Qiong-Ya Guo, Hai-Hui Zhang, Muhammad Noman Khan, Ling Lan, Chang-He Jia, Yan-Rui Zhang, Song-Ze Ding, Henan University School of Medicine, Zhengzhou 450003, Henan Province, China
Author contributions: Yuan L, Lan L, Zhang YR and Ding SZ designed the research; Yuan L, Zhao JB, Zhou YL, Qi YB, Guo QY, Zhang HY, Khan MN and Jia CH collected clinical data and performed experiments; Yuan L analyzed the data; Yuan L and Ding SZ wrote the paper; Ding SZ revised the article; All authors have approved the final version of the manuscript.
Supported by National Natural Science Foundation of China, No. U1604174; Henan Provincial Government-Health and Family Planning Commission, No. 20170123; Henan Provincial Government-Health and Family Planning Commission Research Innovative Talents Project, No. 51282; and Henan Provincial Government-Science and Technology Bureau, No. 142300410050.
Institutional review board statement: This study was approved by the Ethics Committee of People’s Hospital of Zhengzhou University (ID: 2019-KY-No. 10), Zhengzhou, China.
Conflict-of-interest statement: Authors declare no competing interests.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Song-Ze Ding, MD, PhD, Chief Doctor, Professor, Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, No. 7 Weiwu Road, Jinshui District, Zhengzhou 450003, Henan Province, China. dingsongze@hotmail.com
Received: January 4, 2020
Peer-review started: February 24, 2020
First decision: March 27, 2020
Revised: April 8, 2020
Accepted: June 4, 2020
Article in press: June 4, 2020
Published online: July 7, 2020
ARTICLE HIGHLIGHTS
Research background
Type I Helicobacter pylori (H. pylori) is the major form of H. pylori infection in many areas globally. However, its infection status and role in stepwise gastric disease in this gastric cancer prevalent area have not been studied. Its impact on the commonly used gastric cancer risk markers such as gastrin-17 (G-17) and pepsinogens (PGs) is also not known.
Research objectives
We investigated the prevalence of type I and type II H. pylori infection in stepwise gastric diseases and the clinical implications; their impact on G-17 and PGs levels during routine clinical practice were also evaluated.
Research methods
Five hundred and twenty-three hospital admitted patients were enrolled in this study. H. pylori infection was confirmed by both 13C-urea breath test and serological assay. Their serological G-17, PG I, PG II values and PG I/PG II ratio were also measured. Receiver operating characteristic curves were used to calculate the overall diagnostic performance of G-17, PG I, PG II and PG I/PG II ratio in peptic ulcers (PU), chronic atrophic gastritis (CAG) and gastric cancer (GC) patients to determine the best cutoff values, sensitivity and specificity.
Research results
The infection rate of 523 enrolled patients was 76.9%, among which type I H. pylori infection accounted for 72.4%, and type II was 27.6%. Overall, 88.4% of GC patients were H. pylori positive, 84.2% of them were type I infection, and only 11.6% of GC patients were H. pylori negative. H. pylori infection resulted in significantly higher G-17 and PG II values and decreased PG I/PG II ratio. Both types of H. pylori induced higher G-17 level, but type I strain infection resulted in an increased PG II level and decreased PG I/PG II ratio in NAG, NAGE and CAG patients. PG I levels showed no difference among disease groups, and only showed a difference in stratified analysis in GC and PU patients. The diagnostic performance of G-17, PG I, PG II and PG I/PG II ratio in PU, CAG and GC patients indicated relatively low predictive value.
Research conclusions
Type I H. pylori infection is the major form of infection in this geographic region, and a very low percentage (11.6%) of GC patients are not infected by H. pylori. Both types of H. pylori induce an increased G-17 level, while type I H. pylori is the major strain that affects PG I, PG II levels and PG I/PG II ratio in stepwise chronic gastric diseases.
Research perspectives
The results provide insight on H. pylori infection status in hospital admitted patients, and their impact on G-17 and PGs levels, which will be helpful to guide H. pylori eradication and explain G-17 and PGs assay results in clinical practice.
