Predictive value of neutrophil infiltration as a marker of Hel/cobacter pylori infection

AIM： To evaluate the predictive value of neutrophil in- filtration as a marker of Helicobacter pylori （H. pyloni） infection. METHODS： A total of 315 patients with dyspepsia symptoms who underwent upper gastrointestinal en- doscopy were enrolled in this study. Biopsies were evaluated using the updated Sydney system. The medication history of all patients in the preceding 4 wk was recorded. The diagnosis of H. pylori infection was based on 13C-urea breath test at least 4 wk after with- drawal of antisecretory drugs, antibiotics and related drugs. For the patients with subtotal gastrectomy, the diagnosis of H. pylori infection was based on anti-H. pylori immunoglobulin G （IgG） antibody. Serum anti-H. pylori IgG antibody was measured by enzyme-linked immunosorbent assays （Biohit, Finland）. RESULTS： The sensitivity, specificity, positive predic- tive value and negative predictive value of neutrophil infiltration in the diagnosis ofH, pylorlinfection were 92.3%, 83.5%, 77.4% and 94.7%, respectively. Neu- trophil infiltration of gastric mucosa in the histological analysis was strongly associated withH, pylorlinfection （77.4% vs 5.3% in the neutrophil infiltration negative group, P = 0.000）. Moderate neutrophil infiltration was more frequent in H. pylorl infection when compared to mild infiltration （81.8% and 75%, respectively）, but did not reach statistical significance. For those patients with negative rapid urease test, H. pylori was detected in 73.2% of patients with positive neutrophil infiltration on histology. In patients with subtotal gastrectomy, the diagnostic accuracy of neutrophil infiltration in H. pylori infection was 50%. CONCLUSION： Neutrophil infiltration is closely associ- ated withH, pylori and may be recognized as a sign of this infection.