Abstract
Updated data about the prevalence of Helicobacter pylori (H. pylori) and its correlation with histological results are scarce. The aim of our study was to provide current data on the impact of H. pylori in a third-level endoscopy service. We performed a large, retrospective study analyzing the results of all histological samples of gastroscopy from the year 2019. In total, 1512 subjects were included. The prevalence of H. pylori was 16.8%. A significant difference between the prevalence in subjects born in Italy and those from eastern Europe, south America, or Africa was found (p < 0.0001, p = 0.006, and p = 0.0006, respectively). An association was found between H. pylori and active superficial gastritis (p < 0.0001). Current H. pylori and/or a previous finding of H. pylori was related to antral atrophy (p < 0.0001). Fifteen patients had low-grade dysplasia. There were no statistically significant associations with current or past H. pylori infection. One patient presented gastric cardia adenocarcinoma with regular gastric mucosa. One patient, H. pylori positive, was diagnosed with gastric signet ring cell adenocarcinoma in a setting of diffuse atrophy, without metaplasia.. Our study provides updated, solid (biopsy diagnosis and large population) data on the prevalence of H. pylori infection in a representative region of southern Europe.
Highlights
Helicobacter pylori (H. pylori) infection is the most common chronic bacterial infection in the world and is associated with numerous gastro-duodenal diseases such as duodenal ulcer, gastric ulcers, gastritis, gastric adenocarcinoma, and gastric MALT lymphoma [1]
Solid data on the prevalence of H. pylori infection in a representative region of southern Europe
Proton pump inhibitors (PPI) are stopped at least two weeks before gastroscopy Using the hospital’s centralized clinical reporting and archiving system, and the pathological anatomy service’s archiving and reporting system, all patients who underwent gastric biopsies during endoscopy in 2019 were selected
Summary
Helicobacter pylori (H. pylori) infection is the most common chronic bacterial infection in the world and is associated with numerous gastro-duodenal diseases such as duodenal ulcer, gastric ulcers, gastritis, gastric adenocarcinoma, and gastric MALT (mucosa-associated lymphoid tissue) lymphoma [1]. H. pylori infection is the most frequent cause of metaplastic and dysplastic changes in the gastric mucosa and, for this reason, it is classified as a type I carcinogenic factor [5]. The search for H. pylori infection in gastric biopsies during a gastroscopy is the most frequently made request [6]. European guidelines recommend using the “test-and-treat” strategy for H. pylori infection in countries where the prevalence of H. pylori is greater than 20% [5]. The data in the literature indicate that, in Italy, as in other southern European countries (e.g., Spain and Greece), the prevalence of H. pylori in adults appears to be around 50% [7,8].
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