Incidence of Helicobacter Pylori Infections in a group of patients in Erbil City, Kurdistan Region, Iraq and Its Association with Gastritis and Adenocarcinoma

Abstract

Background: Adenocarcinoma is one of the most common causes of Gastric cancer related deaths worldwide. Helicobacter pylori is the causative agent of most cases of gastritis, it can cause chronic active gastritis and known as a risk factor for the development of gastric cancer. This study aimed to assess the prevalence of H. pylori among patients with symptoms of dyspepsia and other gastritis related symptoms and its association with adenocarcinoma.Methods: This study was carried out during the period of January 2018 to October 2019 with a total of 227 patients with gastritis related symptoms. The presence of H. pylori was detected by Rapid Urease Test (RUT) and histo-pathological tests using biopsy specimens. Statistical Analysis was done by using Chi-square test. P < 0.05 was considered to be statistically significant.Results: From the total of 227 patients with gastritis related symptoms, 26 cases (13.61%) were diagnosed with adenocarcinoma. Their ages were between 13 and 90 years with mean of 47.81± 18.23. The result showed that low severity prevalence of H. pylori was highest (111 cases) compared to 17 and 63 cases for high and moderate severity, respectively. Comparison between positive low, moderate, and high H. pylori cases for rapid urease test was highly significant (P<0.000). The results showed no association between H. pylori severity across various age groups and gender. Moreover, goodness of fit test for metaplasia, activity, glandular atrophy, and endoscopic finding across severity status of H. pylori showed highly significant. Four composite categorized groups were initiated based on positive/negative prevalance of H. pylori and adenocarcinoma status. Results revealed statistical significance between combination of H. pylori and adenocarcinoma with inflammation, lymphoid aggregate, metaplasia, activity of neutrophils, glandular atrophy, rapid urease test, and endoscopic findings.Conclusion: Histopathology tests are reliable diagnostic tools for the detection of H. pylori. Data showed that H. pylori was seen more in middle age patients with mucosal lymphoid follicle formation and more than one third of patients with adenocarcinoma. Therefore, screening of these infections is an important strategy for preventing gastric adenocarcinoma.