Type I and type II Helicobacter pylori infection status and their impact on gastrin and pepsinogen level in a gastric cancer prevalent area

doi:10.3748/wjg.v26.i25.3673

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World Journal of Gastroenterology

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World J Gastroenterol. Jul 7, 2020; 26(25): 3673-3685
Published online Jul 7, 2020. doi: 10.3748/wjg.v26.i25.3673

Table 1 Patient clinical data and Helicobacter pylori infection status

Groups	Total patients, n = 523	NAG,n = 213	NAGE,n = 96	PU,n = 94	CAG,n = 77	GC,n = 43	Hp (+),n = 402	Type IHp(+),n = 291	Type II Hp(+),n = 111	Hp (-),n = 121
Age in yr
mean ± SD	53.4 ± 11.6	50.3 ± 11.3^a	53.7 ± 11.3	53.5 ± 13.1	58.0 ± 9.4^a	59.6 ± 7.8^c	53.7 ± 11.4	53.6 ± 11.3	53.9 ± 11.7	52.5 ± 12.1
28-40	76	57 (26.8%)	13 (13.5%)	16 (17.0%)	4 (5.2%)	0	57 (75.0%)	43 (56.6%)^e	15 (19.7%)	18 (23.7%)
41-50	108	71 (33.3%)	21 (21.9%)	17 (18.1%)	7 (9.1%)	6 (14.0%)	78 (72.2%)	55 (50.9%)^e	23 (21.3%)	30 (27.8%)
51-60	191	54 (25.3%)	36 (37.5%)	30 (31.9%)	32 (41.6%)	21 (48.8%)	150 (78.5%)	108 (56.5%)^e	42 (22.0%)	41 (21.5%)
61-80	148	31 (14.6%)	26 (27.1%)	31 (33.0%)	34 (44.2%)	16 (37.2%)	116 (78.4%)	85 (57.5%)^e	31 (20.9%)	32 (21.6%)
Gender
Male	305	105 (49.3%)	52 (54.2%)	68 (70.2%)^g	53 (68.8%)^g	27 (58.3%)^g	234 (76.7%)	167 (54.8%)ⁱ	67 (22.0%)	71 (23.3%)
Female	218	108 (50.7%)	44 (45.8%)	26 (27.7%)	24 (31.2%)	16 (37.3%)	168 (77.1%)	124 (56.9%)ⁱ	44 (20.2%)	50 (22.9%)

Data are presented as n (%), unless otherwise indicted.

^aP < 0.05, mean age in CAG group was compared with NAG group;

^cP < 0.05, mean age in GC group was compared with NAG, NAGE groups;

^eP < 0.05, infection rate of type I H. pylori patients was compared with type II and H. pylori-negative patients in the same age groups;

^gP < 0.05, percentage in male groups was compared with female groups among PU, CAG, and GC groups;

ⁱP < 0.05, infection rate of type I H. pylori patients was compare with type II and Hp-negative patients in the same gender groups. CAG: Chronic atrophic gastritis; GC: Gastric cancer; H. pylori: Helicobacter pylori; NAG: Non-atrophic gastritis; NAGE: Non-atrophic gastritis with erosion; PU: Peptic ulcer; SD: Standard deviation.

Table 2 Infection rates of type I and type II Helicobacter pylori in stepwise chronic gastric diseases

Groups	Total	H. pylori (+)	H. pylori (-)	Type IH. pylori (+)	Type IIH. pylori (+)
NAG	213	140 (65.7)	73 (34.3)	95 (67.9)^a	45 (32.1)
NAGE	96	75 (78.1)^c	21 (21.9)	47 (62.7)^a	28 (37.3)
PU	94	85 (90.4)^c	9 (9.6)	66 (77.6)^a^e	19 (22.4)
CAG	77	64 (83.1)^c	13 (16.9)	51 (79.7)^a^e	13 (20.3)
GC	43	38 (88.4)^c	5 (11.6)	32 (84.2)^a^e	6 (15.8)
Total	523	402 (76.9)	121 (23.1)	291 (72.4)	111 (27.6)

Data are presented as n (%).

^aP < 0.05, when type I H. pylori infection rate was compared with type II H. pylori infection rate in the same disease groups;

^cP < 0.05, when H. pylori infection rate was compared with the rate of control [non-atrophic gastritis (NAG)] group;

^eP < 0.05, when type I H. pylori infection rate was compared with the rate of NAG group. CAG: Chronic atrophic gastritis; GC: Gastric cancer; H. pylori : Helicobacter pylori; NAG: Non-atrophic gastritis; NAGE: Non-atrophic gastritis with erosion; PU: Peptic ulcer.

Table 3 Distribution of CagA, VacA, UreA and UreB serological antibodies in stepwise chronic gastric disease

Groups	CagA	VacA	UreA	UreB
NAG, n = 140	89 (63.6)	82 (55.6)	93 (66.4)	138 (98.6)
NAGE, n = 75	45 (60.0)	36 (48.0)	44 (58.7)	74 (98.7)
PU, n = 85	65 (76.5)	57 (67.0)	67 (78.8)	83 (97.6)
CAG, n = 64	51 (79.7)	43 (67.2)	49 (76.6)	64 (100.0)
GC, n = 38	32 (84.2)	28 (73.7)	31 (81.6)	38 (100.0)
Total, n = 402	282 (70.1)	249 (61.9)	284 (70.6)	397 (98.8)

Data are presented as n (%). CAG: Chronic atrophic gastritis; GC: Gastric cancer; NAG: Non-atrophic gastritis; NAGE: Non-atrophic gastritis with erosion; PU: Peptic ulcer.

Table 4 Effects of Helicobacter pylori infection on gastric gastrin-17, pepsinogen I, pepsinogen II levels and pepsinogen I/II ratios

H. pylori status	n	G-17, pmol/L	PG I, µg/L	PG II, µg/L	PG I/PG II
H. pylori (+)	402	7.9 ± 8.9^a	131.4 ± 86.6	17.3 ±13.2^a	8.4 ± 4.8^a
H. pylori (+)	402	7.9 ± 8.9^a	131.4 ± 86.6	17.3 ±13.2^a	8.4 ± 4.8^a
H. pylori (-)	121	3.6 ± 5.2	117.0 ± 76.7	10.5 ± 9.2	12.8 ± 6.5
Type I H. pylori (+)	291	8.5 ± 9.5^a^c	134.2 ± 86.4	18.7 ± 13.7^a^c	7.7± 4.2^a^c
Type I H. pylori (+)	291	8.5 ± 9.5^a^c	134.2 ± 86.4	18.7 ± 13.7^a^c	7.7± 4.2^a^c
Type II H. pylori (+)	111	6.1 ± 6.5^a	123.9 ± 86.9	13.9 ± 11.0	10.5 ± 5.6^a
Type II H. pylori (+)	111	6.1 ± 6.5^a	123.9 ± 86.9	13.9 ± 11.0	10.5 ± 5.6^a

Data are presented as mean ± standard deviation.

^aP < 0.05, when compared with H. pylori-negative group;

^cP < 0.05, when compared between type I and type II H. pylori-infected groups. G-17: Gastrin-17; H. pylori: Helicobacter pylori; PG I: Pepsinogen I; PG I/PG II : Pepsinogen I/II ratio; PG II: Pepsinogen II.

Table 5 Effects of Helicobacter pylori infection on gastric gastrin 17, pepsinogens levels in stepwise chronic gastric diseases

	NAG	NAGE	PU	CAG	GC
G-17 pmol/L level in different groups,
mean ± SD	5.6 ± 6.2^a	6.7 ± 8.3^a	9.1 ± 12.2	5.1 ± 6.5^a	12.2 ± 7.6
H. pylori (+)	6.9 ± 6.5^a^c	7.5 ± 8.5^a^c	9.5 ± 12.6	5.2 ± 6.8^a	13.0 ± 7.6^c
H. pylori (-)	3.0 ± 4.6	3.9 ± 6.6	5.5 ± 7.4	4.4 ± 5.5	6.0 ± 2.5
Type I H. pylori (+)	7.3 ± 6.7^a^c	7.6 ± 8.4^a^c	10.9 ± 13.8^e	25.3 ± 7.4^a	13.8 ± 7.9^c
Type II H. pylori (+)	6.0 ± 6.2^c	7.3 ± 9.0	4.6 ± 4.9	4.8 ± 3.2	8.9 ± 4.5
PG I µg/L level in different groups,
mean ± SD	116.5 ± 72.4^a^g	116.0 ± 74.2^a^g	168.7 ± 103.7	103.1 ± 60.2^a^g	168.6 ± 103.5
H. pylori (+)	117.0 ± 69.8^g	117.5 ± 74.8^g	172.9 ± 105.0	101.4 ± 64.4^a^g	169.4 ± 104.9
H. pylori (-)	115.4 ± 77.6	110.7 ± 73.6	128.8 ± 86.2	110.3 ± 64.3	162.0 ± 103.7
Type I H. pylori (+)	118.4 ± 67.5^a^g	113.9 ± 62.6^a^g	178.1 ± 109.6	100.6 ± 65.0^a^g	170.8 ± 96.3
Type II H. pylori (+)	114.0 ± 75.1	123.4 ± 92.9	154.9 ± 87.2	105.9 ± 78.6	162.1 ± 154.5
PG II µg/L level in different groups,
mean ± SD	13.7 ± 11.2^a^g	14.4 ± 12.1^a	19.5 ± 14.3	13.8 ± 10.1^a^g	24.5 ± 15.9
H. pylori (+)	15.3 ± 11.3^a^c	15.9 ± 13.0^a^c	20.4 ± 14.7^c	14.8 ± 11.0^a^c	25.1 ± 15.9
H. pylori (-)	10.5 ± 10.2	8.9 ± 5.5	10.8 ± 4.8	8.7 ± 4.3	20.6 ± 16.5
Type I H. pylori (+)	17.1 ± 12.0^c^e	16.5 ± 11.3^c	21.9 ± 16.0^c^e	14.7 ± 11.3^a^c	25.5 ± 16.3
Type II H. pylori (+)	11.5 ± 8.6	14.9 ± 15.5	15.1 ± 6.8	15.4 ± 9.6^c	22.8 ± 15.3
PG I/PG II ratios in different groups,
mean ± SD	10.6 ± 6.3^aⁱ	9.6 ± 5.4^a	9.7 ± 4.3^a	7.9 ± 4.4^a	5.6 ± 3.8
H. pylori (+)	9.3 ± 5.6^a^cⁱ	8.7 ± 4.6^a^c	9.5 ± 4.4^aⁱ	6.8 ± 3.3^c	5.1 ± 3.0
H. pylori (-)	13.2 ± 7.0	13.1 ± 6.7	11.8 ± 3.7	12.8 ± 4.7	9.1 ± 7.3
Type I H. pylori (+)	8.2 ± 4.9^a^c^e	7.8 ± 3.3^a^c^e	9.2 ± 4.2^a	6.5 ± 3.2^c	4.7 ± 2.9^c
Type II H. pylori (+)	11.4 ± 6.3	10.3 ± 5.9	10.7 ± 4.9	8.8 ± 3.4^c	7.6 ± 2.1

^aP < 0.05, vs gastric cancer patients;

^cP < 0.05, vs H. pylori-negative patients in the same disease groups;

^eP < 0.05, type I and type II H. pylori-positive patients were compared in the same disease groups;

^gP < 0.05, vs peptic ulcer patients;

ⁱP < 0.05, vs chronic atrophic gastritis patients. CAG: Chronic atrophic gastritis; G-17: Gastrin 17; GC: Gastric cancer; H. pylori: Helicobacter pylori; NAG: Non-atrophic gastritis; NAGE: Non-atrophic gastritis with erosion; PU: Peptic ulcer; PG I: Pepsinogen I; PG II: Pepsinogen II; PG I/PG II: Pepsinogen I /pepsinogen II ratio.

Citation: Yuan L, Zhao JB, Zhou YL, Qi YB, Guo QY, Zhang HH, Khan MN, Lan L, Jia CH, Zhang YR, Ding SZ. Type I and type II Helicobacter pylori infection status and their impact on gastrin and pepsinogen level in a gastric cancer prevalent area. World J Gastroenterol 2020; 26(25): 3673-3685
URL: https://www.wjgnet.com/1007-9327/full/v26/i25/3673.htm
DOI: https://dx.doi.org/10.3748/wjg.v26.i25.3673