False Sero-Negative Results for Helicobacter Pylori Infection Indicate Increased Risk of Severe Atrophic Gastritis in Japanese Patients
Hitomi Ichikawa1, Mitsushige Sugimoto1, Mihoko Yamade1, Takahiro Uotani1, Shu Sahara1, Takuma Kagami1, Yasushi Hamaya2, Moriya Iwaizumi1, Satoshi Osawa3, Ken Sugimoto1, Hiroaki Miyajima1 and Takahisa Furuta4*
- *Corresponding Author:
- Takahisa Furuta, MD, PhD
Center for Clinical Research
Hamamatsu University School of Medicine
1-20-1, Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
E-mail: [email protected]
Received date: August 13, 2014; Accepted date: September 18, 2014; Published date: September 23, 2014
Citation: Ichikawa H, Sugimoto M, Yamade M, Uotani T, Sahara S, et al. (2014) False Sero-Negative Results for Helicobacter Pylori Infection Indicate Increased Risk of Severe Atrophic Gastritis in Japanese Patients. J Carcinog Mutagen 5:192. doi: 10.4172/2157-2518.1000192
Copyright: © 2014 Ichikawa H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background/objective: H. pylori infection is commonly diagnosed using an anti-H. pylori IgG antibody test. However, a proportion of results are falsely sero-negative. We investigated characteristics of patients falsely seronegative for H. pylori in relation to gastric atrophy. Methods: H. pylori infection (Hp+ or Hp-) was determined based on culture test, rapid urease test (RUT), and polymerase chain reaction (PCR) test in 280 outpatients. Anti-H. pylori antibody titers ≥ 10 U/ml were diagnosed as sero-positive for H. pylori (IgG+), while those <10 U/ml were sero-negative (IgG-). Serum pepsinogen (PG) I/PG II ratios were calculated as a serological marker of gastric atrophy. Endoscopic gastric mucosal atrophy was also assessed according to the Kimura-Takemoto classification system. Results: The mean PG I/PG II ratio in each group was as follows: Hp-/IgG- (4.99 ± 1.04, n=10), Hp+/IgG+ (2.59 ± 1.51, n=240), Hp-/IgG+ (5.65 ± 2.72, n=4) and Hp+/IgG- (3.02 ± 2.61, n=26). The mean serum PG I/PG II ratio in the Hp+/IgG- group was lower than those of Hp-/IgG- and Hp-/IgG+ groups (P=0.028 and 0.072). Incidence of severe gastric mucosal atrophy in the Hp+/IgG- group was highest of the four groups. Conclusions: Individuals falsely sero-negative for H. pylori infection is at increased risk of severe atrophic gastritis, which is well known as precancerous lesion.