[Relationship between Helicobacter pylori infection and histopathological features of nodular gastritis in children]
Juan Zhang1, Zai-Ling Li, Jing Sui
1Department of Pediatrics, Beijing University Third Hospital, Beijing 100191, China. topbj163@sina.com.
Insights
Nodular gastritis (NG) in children is a strong indicator of Helicobacter pylori (Hp) infection. This endoscopic finding, associated with significant gastric inflammation, suggests Hp eradication therapy is crucial for treating NG.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Histopathology
Background:
- Nodular gastritis (NG) is an endoscopic finding in the gastric mucosa.
- Helicobacter pylori (Hp) infection is a common cause of gastritis in children.
Purpose of the Study:
- To investigate the association between Helicobacter pylori (Hp) infection and the histopathological characteristics of nodular gastritis (NG) in pediatric patients.
- To evaluate the diagnostic utility of NG as an endoscopic marker for Hp infection in children.
Main Methods:
- A cohort of 213 children with upper gastrointestinal symptoms underwent gastroscopy.
- Children were classified into NG and non-NG groups based on endoscopic findings.
- Gastric mucosal histopathology was analyzed using the updated Sydney System, comparing Hp infection rates, inflammation severity, and lymphoid follicle formation between groups.
Main Results:
- Nodular gastritis (NG) was diagnosed in 17.8% of children.
- The NG group exhibited significantly higher rates of Hp infection (86.8%), moderate to severe inflammation (81.6%), and lymphoid follicle formation (52.6%) compared to the non-NG group (P<0.01).
- NG demonstrated high specificity (96.8%) and positive predictive value (86.8%) for Hp infection diagnosis.
Conclusions:
- Nodular gastritis (NG) serves as a specific endoscopic sign of Hp infection in children, characterized by significant gastric inflammation.
- NG can be utilized as a reliable endoscopic indicator for diagnosing Hp infection in pediatric populations.
- Helicobacter pylori eradication therapy is recommended for managing nodular gastritis in children.
Objective:
To study the relationship between Helicobacter pylori (Hp) infection and histopathological features of nodular gastritis (NG) in children.
Methods:
A total of 213 children who had undergone gastroscopy due to upper gastrointestinal symptoms were enrolled and were divided into NG and non-NG groups according to endoscopic appearance. The histopathological features of gastric mucosa were evaluated using the updated Sydney System. The rates of Hp infection, moderate to severe inflammation and lymphoid follicles formation of gastric mucosa were compared between the two groups.
Results:
Thirty-eight (17.8%) of the subjects were diagnosed with NG. The NG group had significantly increased rates of Hp infection (86.8% vs 14.3%; P<0.01), moderate to severe inflammation (81.6% vs 15.4%; P<0.01) and lymphoid follicles formation of gastric mucosa (52.6% vs 10.3%; P<0.01) compared with the non-NG group. NG had a high specificity (96.8%) and a positive predictive value (86.8%) for the diagnosis of Hp infection. NG was observed in 33 (56.9%) of 58 Hp-positive children and in 5 (3.2%) of 155 Hp-negative children (P<0.01). Hp-positive children had higher rates of moderate to severe inflammation (86.2% vs 5.2%, P<0.01) and lymphoid follicles formation of gastric mucosa (84.2% vs 14.9% P<0.01) compared with Hp-negative children. There were significant differences in Hp colonization, degree of inflammation and inflammation activity in gastric tissues between the NG and non-NG groups (P<0.01).
Conclusions:
NG is a special sign of Hp infection in children, which mostly shows moderate to severe inflammation of gastric mucosa, and can be used as an endoscopic indicator of Hp infection. Hp eradication therapy should be considered in the treatment of NG.
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