Toyoshima O, Nishizawa T, Arita M, Kataoka Y, Sakitani K, Yoshida S, Yamashita H, Hata K, Watanabe H, Suzuki H. Helicobacter pylori infection in subjects negative for high titer serum antibody. World J Gastroenterol 2018; 24(13): 1419-1428 [PMID: 29632423 DOI: 10.3748/wjg.v24.i13.1419]
Corresponding Author of This Article
Osamu Toyoshima, MD, Director, Department of Gastroenterology, Toyoshima Endoscopy Clinic, 6-17-5 Seijo, Setagaya-ku, Tokyo 1570066, Japan. t@ichou.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Toyoshima O, Nishizawa T, Arita M, Kataoka Y, Sakitani K, Yoshida S, Yamashita H, Hata K, Watanabe H, Suzuki H. Helicobacter pylori infection in subjects negative for high titer serum antibody. World J Gastroenterol 2018; 24(13): 1419-1428 [PMID: 29632423 DOI: 10.3748/wjg.v24.i13.1419]
Osamu Toyoshima, Toshihiro Nishizawa, Masahide Arita, Yosuke Kataoka, Kosuke Sakitani, Shuntaro Yoshida, Hiroharu Yamashita, Keisuke Hata, Department of Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 1570066, Japan
Hidenobu Watanabe, Department of Pathology, Pathology and Cytology Laboratory Japan, Tokyo 1660003, Japan
Hidekazu Suzuki, Medical Education Center, Keio University School of Medicine, Tokyo 1608582, Japan
Author contributions: All authors were involved in designing the study; Toyoshima O, Nishizawa T and Suzuki H prepared the manuscript; Watanabe H was involved with histological diagnoses; Toyoshima O contributed to statistical analyses.
Institutional review board statement: This retrospective study was approved by the Ethical Review Committee of Hattori Clinic on September 7, 2017.
Informed consent statement: Written informed consents were obtained from the participants.
Conflict-of-interest statement: During the last five years, Toyoshima O received personal fees from Otsuka Pharmaceutical Co., Ltd. and Takeda Pharmaceutical Co., Ltd. outside of the submitted work; Suzuki H received scholarship funds for the research from Astellas Pharma Inc., Astra-Zeneca K.K., Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., and Zeria Pharmaceutical Co., Ltd. and received service honoraria from Astellas Pharma, Inc., Astra-Zeneca K.K., Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., and Zeria Pharmaceutical Co., Ltd.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Correspondence to: Osamu Toyoshima, MD, Director, Department of Gastroenterology, Toyoshima Endoscopy Clinic, 6-17-5 Seijo, Setagaya-ku, Tokyo 1570066, Japan. t@ichou.com
Telephone: +81-3-54299555 Fax: +81-3-54299511
Received: February 25, 2018 Peer-review started: February 25, 2018 First decision: March 9, 2018 Revised: March 13, 2018 Accepted: March 18, 2018 Article in press: March 18, 2018 Published online: April 7, 2018 Processing time: 38 Days and 11.8 Hours
ARTICLE HIGHLIGHTS
Research background
Patients who test negative but in the negative-high titer range of serum anti-Helicobacter pylori (H. pylori) antibodies are at a high risk for gastric cancer, especially the intestinal type, and sometimes have H. pylori infection. Patients with negative-high titers with H. pylori infection have higher risk for gastric cancer than do those without H. pylori infection.
Research motivation
The clinicopathological features including H. pylori infection rate in the negative-high titer patients are unclear.
Research objectives
The objective of this research was to elucidate the clinicopathological features of the negative-high titer patients.
Research methods
The antibody titers were measured using antigens derived from Japanese individuals, E-plate Eiken. 13C-urea breath test (UBT)-positive individuals were defined as having H. pylori infection. We investigated the demographic characteristics, laboratory data, endoscopic findings including Kyoto classification of gastritis, and histology in negative-high titer patients without history of H. pylori eradication therapy.
Research results
Of the 136 subjects enrolled, 23 (17%) had H. pylori infection. Kyoto classification had an excellent area under the receiver operating characteristics curve (0.886) for predicting H. pylori infection, with a cut-off value of 2. Further, Kyoto classification had high accuracy (89.7%). Kyoto classification was independent of the demographic and laboratory parameters in multivariate analysis.
Research conclusions
In this study, 17% of patients with negative-high titer had H. pylori infection. Endoscopic Kyoto classification of gastritis with a score of 2 or more could predict H. pylori infection in negative high-titer patients. Further investigations including UBT should be considered in these patients.
Research perspectives
Long-term prospective studies are expected to investigate the role of serum antibody titer and Kyoto classification of gastritis in predicting not only H. pylori infection but also the risk of gastric cancer.
