CagA , VacA and urease can assist in predicting the development trend of chronic gastritis

Abstract Background The virulence factors about CagA and VacA of Helicobacter pylori are thought to induce more serious gastric disorders and histological alterations, while the urease is regarded as a common virulence factor, which does not result in more severe outcomes. Now, there are few papers that systematically depict the association between the three virulence factors and the histopathology of chronic gastritis in Xinjiang. Methods From January 2018 to December 2022, we enrolled 1923 chronic gastritis patients who received endoscopy and were confirmed by pathology at the People's Hospital of Xinjiang Uygur Autonomous Region. All the included patients were first-time tested for Helicobacter pylori infection and had no eradication treatment history. Selected chronic non-atrophic gastritis and chronic atrophic gastritis as the main research subjects. Histopathological evaluation was performed according to the Sydney system. All the patients underwent serologic detection of CagA, VacA and urease (enzyme-linked immunosorbent assay). We gathered the basic clinical data, serologic data, endoscopic and pathologic data of all the patients. Results Among 1923 chronic gastritis patients (1137 Han, 521 Uighur, 140 Kazakh, 125 Hui ; mean age: 56.73 ± 12.84), there are 1064 chronic non-atrophic gastritis and 859 chronic atrophic gastritis and significant difference between the two groups (χ2 = 10.27, P = 0.160). Further subgroup analyses of the proportions of different ethnic groups between the two types of gastritis showed a statistically significant difference only between Han and Uyghur groups (χ2 = 7.814, P = 0.005). The positivity rates of CagA, VacA and urease were statistically lower in Han than in Uyghur (χ2 = 27.92, P = 0.000; χ2 = 36.36, P = 0.000; χ2 = 11.814, P = 0.001). Most importantly, the positivity rates of CagA, VacA and urease rose with the rise of the seriousness of gastritis inflammation and activity, but there was no notable statistical discrepancy between the atrophy and intestinalization. Besides, the mean age of CagA, VacA and urease positivity rates in Han patients was usually higher than that in Uyghur, Kazakh and Hui patients. Conclusions The relationship between the three virulence factors and the histopathological grading has its own characteristics in Xinjiang. The detection of CagA, VacA, and urease is more suitable to predict the development trend of chronic gastritis for Uyghur patients.