Gastric mucosal precancerous lesions in Helicobacter pylori-infected pediatric patients in central China: A single-center, retrospective investigation

doi:10.3748/wjg.v28.i28.3682

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Jul 28, 2022 (publication date) through Nov 26, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Jul 28, 2022; 28(28): 3682-3694
Published online Jul 28, 2022. doi: 10.3748/wjg.v28.i28.3682

Table 1 Demographic and clinical data of patients

Variables	Total	*H. pylori*+	*H. pylori*-	P value
Patients, n	1015	854	161
Age in year, median (IQR)	11 (9-13)	11 (9-13)	9 (6-12)	< 0.001^a
Sex, n (%)
Female	411 (40.49)	346 (40.52)	65 (40.37)
Male	604 (59.51)	508 (59.48)	96 (59.63)	0.973
Endoscopic pattern, n (%)
Esophagitis	28 (2.76)	23 (2.69)	5 (3.11)	0.975
Superficial gastritis	331 (32.61)	255 (29.86)	76 (47.20)	< 0.001^b
Superficial gastritis with erosion	236 (23.25)	200 (23.42)	36 (22.36)	0.77
Superficial gastritis with bile reflux	295 (29.06)	251 (29.39)	44 (27.33)	0.597
Antral nodularity	135 (13.30)	131 (15.34)	4 (2.48)	< 0.001^b
Peptic ulcer	90 (8.87)	80 (9.37)	10 (6.21)	0.196
Atrophic gastritis	18 (1.77)	17 (1.99)	1 (0.62)	0.378
Clinical diagnosis, n (%)
Esophagitis	28 (2.76)	23 (2.69)	5 (3.11)	0.975
Non atrophic gastritis	997 (98.23)	837 (98.01)	160 (99.38)	0.378
Atrophic gastritis	18 (1.77)	17 (1.99)	1 (0.62)	0.378
Gastric ulcer	18 (1.77)	16 (1.87)	2 (1.24)	0.817
Duodenal ulcer	72 (7.09)	64 (7.49)	8 (4.97)	0.252

^aP < 0.05: Median age was compared between Helicobacter pylori (H. pylori)-positive and -negative groups.

^bP < 0.05: When compared between H. pylori–positive and –negative within each disease group.

IQR: Interquartile range; H. pylori: Helicobacter pylori.

Table 2 Helicobacter pylori infection status in different age groups

Age group	Sex, n (male/female)	**H. pylori+, n (%)**	**H. pylori-, n (%)**
1-4	54 (29/25)	22 (40.74)	32 (59.26)
5-8	199 (111/88)	156 (78.39)^a	43 (21.61)
9-12	435 (286/149)	383 (88.05)^a^,^b	52 (11.95)
13-18	327 (178/149)	293 (89.60)^a^,^b	34 (10.40)
Total	1015 (604/411)	854 (84.14)	161 (15.86)

^aP < 0.05: When Helicobacter pylori (H. pylori) infection rates were compared with the 1-4 years age group.

^bP < 0.05: When H. pylori infection rates were compared with the 5-8 years age group.

H. pylori: Helicobacter pylori.

Table 3 Precancerous lesions in the gastric mucosa in children and adolescents

Age group	*H. pylori*+				Subtotal	*H. pylori*-				Subtotal
Age group	n	Atrophy	IM	Dysplasia	Subtotal	n	Atrophy	IM	Dysplasia	Subtotal
1-4	22	1	1	1	3	32	0	0	0	0
5-8	156	4	4	1	9	43	0	0	0	0
9-12	383	6	3	6	15	52	0	0	0	0
13-18	293	6	3	1	10	34	1	0	0	1
Total	854	37 (4.33%)^a				161	1 (0.62%)

^aP < 0.05: The incidence of gastric mucosal precancerous lesions was compared between Helicobacter pylori (H. pylori)-positive and H. pylori-negative patients.

IM: Intestinal metaplasia; H. pylori: Helicobacter pylori.

Table 4 Comparison of active inflammation between Helicobacter pylori-positive and -negative patients

Age group	*H. pylori*+			*H. pylori*-
Age group	n	Active inflammation	Non-active inflammation	n	Active inflammation	Non-active inflammation
1-4	22	3 (13.64)	19 (86.36)	32	2 (6.25)	30 (93.75)
5-8	156	23 (14.74)^a	133 (85.26)	43	1 (2.33)	42 (97.67)
9-12	383	52 (13.58)^b	331 (86.42)	52	2 (3.85)	50 (96.15)
13-18	293	59 (20.14)^c	234 (79.86)	34	1 (2.94)	33 (97.06)
Total	854	137 (16.04)^d	717 (83.96)	161	6 (3.73)	155 (96.27)

^aP < 0.05: Active inflammation in Helicobacter pylori (H. pylori)-positive patients were compared with -negative patients in the 5-8 years age group.

^bP < 0.05: Active inflammation in H. pylori-positive patients was compared with -negative patients in the 9-12 years age group.

^cP < 0.05: Active inflammation in H. pylori-positive patients was compared with -negative patients in the 13-18 years age group.

^dP < 0.05: Active inflammation was compared between the H. pylori-positive and -negative groups.

Data are n (%), unless otherwise indicated. H. pylori: Helicobacter pylori.

Table 5 Degree of neutrophil granulocyte infiltration in Helicobacter pylori-positive and -negative patients

Age group	*H. pylori*+				*H. pylori*+				Z	P value
Age group	n	Absent	Mild	Moderate	n	Absent	Mild	Moderate	Z	P value
1-4	22	19 (86.36)	3 (13.64)	0 (0)	32	30 (93.75)	2 (6.25)	0 (0)	0.912	0.362
5-8	156	133 (85.26)	21 (13.46)	2 (1.28)	43	42 (97.67)	1 (2.33)	0 (0)	2.212	0.027^a
9-12	383	331 (86.42)	44 (11.49)	8 (2.09)	52	50 (96.15)	2 (3.85)	0 (0)	2.009	0.045^b
13-18	293	234 (79.86)	48 (16.38)	11 (3.76)	34	33 (97.06)	1 (2.94)	0 (0)	2.456	0.014^c
Total	854	717 (83.96)	116 (13.58)	21 (2.46)	161	155 (96.27)	6 (3.73)	0 (0)	4.319	< 0.001^d

^aP < 0.05: Degree of neutrophil granulocyte infiltration in Helicobacter pylori (H. pylori)-positive patients were compared with -negative patients in the 5-8 years age group.

^bP < 0.05: Degree of neutrophil granulocyte infiltration in H. pylori-positive patients was compared with -negative patients in the 9-12 years age group.

^cP < 0.05: Degree of neutrophil granulocyte infiltration in H. pylori-positive patients was compared with -negative patients in the 13-18 years age group.

^dP < 0.05: Degree of neutrophil granulocyte infiltration was compared between H. pylori-positive and -negative groups.

Data are n (%), unless otherwise indicated. H. pylori: Helicobacter pylori.

Table 6 Degree of lymphocyte infiltration in Helicobacter pylori-positive and -negative patients

Age group	*H. pylori*+				*H. pylori*-				Z	P value
Age group	n	Mild	Moderate	Marked	n	Mild	Moderate	Marked	Z	P value
1-4	22	10 (45.45)	11 (50)	1 (4.55)	32	17 (53.12)	14 (43.75)	1 ( 3.13)	0.57	0.569
5-8	156	67 (42.95)	75 (48.08)	14 (8.97)	43	24 (55.81)	18 (41.86)	1 (2.33)	1.737	0.082
9-12	383	161 (42.04)	195 (50.91)	27 (7.05)	52	31 (59.62)	20 (38.46)	1 (1.92)	2.539	0.01^a
13-18	293	112 (38.23)	151 (51.54)	30 (10.24)	34	19 (55.88)	14 (41.18)	1 (2.94)	2.164	0.03^b
Total	854	350 (40.98)	432 (50.59)	72 (8.43)	161	91 (56.52)	66 (40.99)	4 (2.48)	3.997	< 0.00^c

^aP < 0.05: Degree of lymphocyte infiltration in Helicobacter pylori (H. pylori)-positive patients were compared with -negative patients in 9-12 years age group.

^bP < 0.05: Degree of lymphocyte infiltration in H. pylori-positive patients were compared with -negative patients in 13-18 years age group.

^cP < 0.05: Degree of lymphocyte infiltration was compared between H. pylori-positive and -negative groups.

Data are n (%), unless otherwise indicated. H. pylori: Helicobacter pylori.

Citation: Yu M, Ma J, Song XX, Shao QQ, Yu XC, Khan MN, Qi YB, Hu RB, Wei PR, Xiao W, Jia BL, Cheng YB, Kong LF, Chen CL, Ding SZ. Gastric mucosal precancerous lesions in Helicobacter pylori-infected pediatric patients in central China: A single-center, retrospective investigation. World J Gastroenterol 2022; 28(28): 3682-3694
URL: https://www.wjgnet.com/1007-9327/full/v28/i28/3682.htm
DOI: https://dx.doi.org/10.3748/wjg.v28.i28.3682