Helicobacter pylori infection in Xinjiang Uyghur Autonomous Region: Prevalence and analysis of related factors

Table 1 The essential epidemic features of cases detected Helicobacter pylori with immunohistochemical staining and ¹⁴C urea breath test methods (n = 5747)

Characteristics		Total	Han	Uyghur
Gender (cases)	Male	2672 (46.5%)	2303 (46.8%)	369 (44.9%)
	Female	3075 (35.5%)	2622 (53.2%)	453 (55.1%)
Age (yr)	Range	19-92	19-92	22-80
	Average	56.3	56.7	53.4
	Median	56.0	56.0	54.0
Residing region (cases)	Northern Xinjiang	4919 (85.6%)	4405 (89.4%)	514 (62.5%)
	Southern Xinjiang	508 (8.8%)	207 (4.2%)	301 (36.6%)
	Xinjiang Production and Construction Corps	265 (4.6%)	263 (5.3%)	2 (0.2%)
	Extra Xinjiang Uyghur Autonomous Region	55 (1.0%)	50 (1.0%)	5 (0.6%)
Total (cases)		5747	4925 (85.7%)	822 (14.3%)

Table 2 Comparison of differences between immunohistochemical staining and ¹⁴C urea breath test for detecting Helicobacter pylori infection (n = 3944)

			H. pylori positive rate (%)
			Positive1	Negative1	P value1	Positive2	Negative2	P value (single vs multiple biopsy)2
14C UBT (total, n = 3944)		Positive	1176 (29.8%)	685 (17.4%)	P < 0.001	1962 (49.7%)	1982 (50.3%)	-
		Negative	101 (2.6%)	1982 (50.3%)
Subgroup	Single biopsy (1 piece, n = 3476)	Positive	987 (28.4%)	608 (17.5%)	P < 0.001	1068 (30.7%)	2408 (69.3%)	P < 0.001
		Negative	81 (2.3%)	1800 (51.8%)
	Multiple biopsies (≥ 2 pieces, n = 468)	Positive	189 (40.4%)	77 (16.5%)	P < 0.001	209 (44.7%)	259 (55.3%)
		Negative	20 (4.3%)	182 (38.9%)

¹Immunohistochemical staining.

²Immunohistochemical staining & ¹⁴C urea breath test combined.

¹⁴C UBT: ¹⁴C urea breath test; H. pylori: Helicobacter pylori.

Table 3 Comparison of the differences between immunohistochemical staining and ¹⁴C urea breath test and the in detecting Helicobacter pylori infection at different value range levels (n = 3944)

Qualitative results1	Value ranges (dpm/mmol)1	Positive2	Negative2	Positive ratio (%)2	IHC positive rate2
Negative (n = 2083)	0-49	80	1813	4.2	4.8% (101/2083)
	50-100	21	169	11.1
Positive (n = 1861)	101-199	46	134	25.6	63.2% (1176/1861)
	200-499	193	174	52.6
	500-999	324	161	66.8
	≥ 1000	613	216	73.9

¹Helicobacter pylori of ¹⁴C urea breath test.

²Immunohistochemical staining for Helicobacter pylori.

IHC: Immunohistochemistry.

Table 4 Comparison of Helicobacter pylori infection rates between Han and Uyghur undergoing gastroscopy examination among accurately matched pairs (n = 555)

Method	H. pylori positive rate
	Male (n = 249)1	Female (n = 306)1	P value (male/female, Pearson)1	Subtotal (n = 555)1	Male (n = 249)2	Female (n = 306)2	P value (male/female, Pearson)2	Subtotal (n = 555)2	P value (total, Han and Uyghur), Pearson
IHC	89 (35.7%)	65 (21.2%)	P < 0.001	154 (27.7%)	134 (53.8%)	161 (52.6%)	P = 0.778	295 (53.2%)	P < 0.001
14C UBT	111 (44.6%)	101 (33.0%)	P = 0.005	212 (38.2%)	170 (68.3%)	216 (70.0%)	P = 0.556	386 (69.5%)	P < 0.001
IHC & 14C UBT	118 (47.4%)	112 (36.6%)	P = 0.012	230 (41.4%)	180 (72.3%)	227 (74.2%)	P = 0.630	407 (73.3%)	P < 0.001

¹Han.

²Uyghur.

¹⁴C UBT: ¹⁴C urea breath test; H. pylori: Helicobacter pylori; IHC: Immunohistochemistry; Pearson: Pearson χ² test.

Table 5 Helicobacter pylori infection among main disease types diagnosed by biopsies from endoscopy in Xinjiang Uyghur Autonomous Region (n = 5747)

Classification of disease	Pathological diagnosis	H. pylori positive rate
		IHC	IHC & 14C UBT combined
Benign lesions	Gastritis	35.8% (1652/4609)	53.8% (2478/4609)
	Duodenal ectopic gastric mucosa	19.4% (7/36)	22.2% (8/36)
	Gastric fundic gland polyps	17.3% (76/440)	27.5% (121/440)
	Hyperplastic (regenerative) polyps	7.4% (37/502)	17.5% (88/502)
	Ulcer	50.0% (2/4)	100% (4/4)
	Xanthoma	66.7% (2/3)	100% (3/3)
Pre-malignant lesions	Barrett’s esophagus	41.3% (38/92)	58.7% (54/92)
	Duodenal LGIN	100% (1/1)	100% (1/1)
	Gastric LGIN	55.6% (5/9)	55.6% (5/9)
	Esophageal HGIN	50.0% (1/2)	100% (2/2)
	Gastric HGIN	28.6% (2/7)	57.1% (4/7)
	Esophageal HGIN	0% (0/2)	0% (0/2)
Malignant tumors	Gastric adenocarcinoma	41.2% (14/34)	67.6% (23/34)
	Lymphoma	75.0% (3/4)	75% (3/4)
	Neuroendocrine tumor	0% (0/1)	0% (0/1)
	GIST	0% (0/1)	0% (0/1)

¹⁴C UBT: ¹⁴C urea breath test; HGIN: High-grade intraepithelial neoplasia; H. pylori: Helicobacter pylori; IHC: Immunohistochemistry; LGIN: Low-grade intraepithelial neoplasia; GIST: Gastrointestinal stromal tumor.

Table 6 Correlation between grading (chronic/active, atrophy, intestinal metaplasia grade) and Helicobacter pylori infection rate in gastritis

Characteristics	Grading	H. pylori positive rate
		IHC	IHC & 14C UBT combined1	P value
Chronic	G1	13.3% (312/2348)	29.9% (703/2348)	P < 0.0012
	G2	65.6% (1110/1692)	85.2% (1441/1692)
	G3	81.3% (148/182)	95.6% (174/182)
Active	G0	10.5% (229/2174)	27.6% (599/2174)	P < 0.0012
	G1	54.1% (626/1157)	74.9% (867/1157)
	G2	80.3% (705/878)	95.6% (839/878)
	G3	76.9% (10/13)	100% (13/13)
Atrophy	G0	37.0% (1367/3697)	54.4% (2010/3697)	P = 0.0841
	G1	37.2% (170/457)	57.3% (262/457)
	G2	46.6% (27/58)	65.5% (38/58)
	G3	60.0% (6/10)	80.0% (8/10)
Intestinal metaplasia	G0	38.8% (1235/3183)	55.6% (1771/3183)	P = 0.0321
	G1	30.9% (289/934)	48.6% (480/934)
	G2	43.8% (42/96)	63.5% (61/96)
	G3	44.4% (4/9)	66.7% (6/9)

¹Fisher’s exact probability method.

²Pearson χ² test.

¹⁴C UBT: ¹⁴C urea breath test; G0: Grade 0 = none; G1: Grade1 = mild; G2: Grade 2 = moderate; G3: Grade 3 = severe; H. pylori: Helicobacter pylori; IHC: Immunohistochemistry.