Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2022; 28(28): 3682-3694
Published online Jul 28, 2022. doi: 10.3748/wjg.v28.i28.3682
Gastric mucosal precancerous lesions in Helicobacter pylori-infected pediatric patients in central China: A single-center, retrospective investigation
Miao Yu, Jing Ma, Xiao-Xia Song, Qiao-Qiao Shao, Xue-Chun Yu, Muhammad Noman Khan, Ya-Bin Qi, Ruo-Bing Hu, Pei-Ru Wei, Wei Xiao, Bai-Ling Jia, Yan-Bo Cheng, Ling-Fei Kong, Chuan-Liang Chen, Song-Ze Ding
Miao Yu, Jing Ma, Qiao-Qiao Shao, Xue-Chun Yu, Muhammad Noman Khan, Ya-Bin Qi, Ruo-Bing Hu, Pei-Ru Wei, Wei Xiao, Bai-Ling Jia, Song-Ze Ding, Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
Xiao-Xia Song, Ling-Fei Kong, Department of Pathology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
Yan-Bo Cheng, Department of Pediatrics, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
Chuan-Liang Chen, Department of Medical Imaging, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
Author contributions: Yu M, Cheng YB, Jia BL, Kong LF, Chen CL and Ding SZ designed the research; Yu M, Song XX, Ma J, Shao QQ, Yu XC, Khan MN, Qi YB, Hu RB, Wei PR and Xiao W collected the clinical data and performed the experiments; Yu M analyzed the data; Yu M and Ding SZ wrote the paper; Ding SZ revised the article; all authors approved the final version of the manuscript.
Supported by the National Natural Science Foundation of China, No. U1604174; Henan Provincial Government-Health and Family Planning Commission, No. 20170123 and No. SBGJ202002004; and Henan Provincial Government-Health and Family Planning Commission Research Innovative Talents Project, No. 51282.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of People’s Hospital of Zhengzhou University (2019-KY-No. 10).
Informed consent statement: The study was performed retrospectively. Patients were not required to give informed consent for the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare that there are no conflicts of interests related to this work.
Data sharing statement: No additional data are available.
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: Song-Ze Ding, MD, PhD, Professor, Department of Gastroenterology and Hepatology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, No. 7 Weiwu Road, Jinshui District, Zhengzhou 450003, Henan Province, China. dingsongze@hotmail.com
Received: January 9, 2022
Peer-review started: January 9, 2022
First decision: March 8, 2022
Revised: April 2, 2022
Accepted: June 21, 2022
Article in press: June 21, 2022
Published online: July 28, 2022
ARTICLE HIGHLIGHTS
Research background

Chronic Helicobacter pylori (H. pylori) infection causes gastric mucosal precancerous lesions and gastric cancer in adult patients. It remains to be determined, however, whether gastric mucosal precancerous lesions may also occur in children and adolescents, as this remains an important issue for clinical intervention.

Research motivation

Investigating the relationship between H. pylori infection and gastric mucosal precancerous lesions in pediatric patients will provide important evidence on whether intervention should be offered to prevent related disease development in this population group.

Research objectives

H. pylori infection status, gastric mucosal inflammation and gastric precancerous lesions in hospitalized pediatric patients were investigated in central China.

Research methods

We retrospectively enrolled 1015 symptomatic pediatric patients to analyze their clinical and path-ological data. The endoscopic and histological findings, occurrence of gastric mucosal precancerous lesions, inflammatory activity and degree of inflammatory cell infiltration were analyzed between H. pylori-positive and -negative patient groups.

Research results

The overall H. pylori infection rate was 84.14% for the 1015 enrolled pediatric patients, and infection rate increased with age. The incidence of gastric mucosal precancerous lesions in H. pylori-infected children was 4.33%, which was significantly higher than that in H. pylori-negative children. Infected patients showed more active inflammation as well as more severe inflammatory cell infiltration compared to the non-infected patients. Additionally, endoscopy revealed that the most common presentation was antral nodularity in H. pylori-positive patients, whereas superficial gastritis was a marked feature for H. pylori-negative patients.

Research conclusions

In children and adolescents, gastric mucosal precancerous lesions occurred in 4.33% of H. pylori-infected patients in central China. The data revealed an obvious critical issue that requires future investigation and intervention for this population group.

Research perspectives

The results provide insights on H. pylori infection status and its relationship with gastric mucosal precancerous in symptomatic pediatric patients in central China. Further investigation and intervention for related disease prevention are required in this population group.